院前EMS对AIS患者发病-溶栓时间及溶栓疗效的影响  

Influence of pre hospital emergency intervention on onset thrombolysis time of patients with acute ischemic stroke and analysis of thrombolytic effect

作　　者：赵扬[1] 袁宇凤 颜源均 李良 ZHAO Yang;YUAN Yu-feng;YAN Yuan-jun;LI Liang(Center of Clinical Skills,North Sichuan Medical College;Department of Emergency,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan,China)

机构地区：[1]川北医学院临床技能中心 [2]川北医学院附属医院急诊科,四川南充637000

出　　处：《川北医学院学报》2021年第6期762-765,共4页Journal of North Sichuan Medical College

基　　金：四川省南充市社科联项目(NC2013B026)。

摘　　要：目的:探讨院前急救干预(EMS)对急性缺血性脑卒中(AIS)患者发病-溶栓时间及溶栓疗效的影响。方法:选取接受静脉溶栓救治的80例AIS患者为研究对象,按就诊前是否启动EMS方式分为EMS组(启动EMS,n=36)和非EMS组(未启动EMS,n=44);比较两组患者发病至入院时间(ODT)、入院至溶栓开始治疗时间(DNT)、发病至溶栓时间(OTN)、DNT达标率和溶栓疗效,并分析影响溶栓疗效的因素。结果:EMS组ODT、DNT、OTN短于非EMS组(P<0.05),DNT达标率及治疗1周溶栓有效率高于非EMS组(P<0.05);多因素Logistic回归分析显示,AIS患者NIHSS评分及启动EMS是影响溶栓疗效的主要因素。结论:入院基线NIHSS评分、是否启动EMS、OTN均是AIS患者溶栓疗效的影响因素,启动EMS能明显缩短患者OTN,节约治疗时间,提高溶栓疗效。Objective:To explore the effect of pre hospital emergency intervention(EMS)on onset thrombolysis time(OTN)in patients with acute ischemic stroke(AIS),and to analyze the related factors affecting the thrombolytic effect.Methods:80 patients with AIS who received intravenous thrombolysis were selected as the subjects.According to whether EMS was started before the visit,they were divided into EMS group(start EMS,n=36)and non EMS group(self transport,n=44).The time from onset to admission(ODT),time from admission to thrombolytic therapy(DNT),time from onset to thrombolytic therapy(OTN),DNT compliance rate and thrombolytic efficacy were compared between the two groups,and the factors affecting the efficacy of thrombolysis were analyzed.Results:The ODT,DNT and OTN in EMS group were shorter than those in non EMS group(P<0.05),and the rate of DNT standard and thrombolysis effectiveness in 1 week were higher than those in non EMS group(P<0.05).Multivariate logistic regression analysis showed that baseline NIHSS score and initiation of EMS were the influencing factors of thrombolytic efficacy.Conclusion:Baseline NIHSS score,whether to start EMS and OTN are the influencing factors of thrombolytic effect in AIS patients.Starting EMS can significantly shorten the OTN of AIS patients,save treatment time and improve the thrombolytic effect.

关 键 词：急性缺血性脑卒中 院前急救干预 静脉溶栓 入院至溶栓时间 溶栓疗效 

分 类 号：R743.3[医药卫生—神经病学与精神病学]