流程质控在急性缺血性卒中静脉溶栓治疗中的临床研究  

Clinical Study of Process Quality Control in Intravenous Thrombolysis in Acute Ischemic Stroke

作　　者：许香香[1] 陈宝春[1] 林凤芹 XU Xiangxiang;CHEN Baochun;LIN Fengqin(Emergency Department,Dongtai People's Hospital,Dongtai,Jiangsu Province,224200 China)

机构地区：[1]东台市人民医院急诊科,江苏东台224200

出　　处：《系统医学》2022年第4期78-81,85,共5页Systems Medicine

摘　　要：目的探讨流程质控在急性缺血性卒中静脉溶栓治疗中的临床效果。方法选择2019年6月—2021年7月该院接受的168例急性缺血性卒中患者作为对象,将2019年6月—2020年6月未采用流程质控诊治的82例患者作为对照组,将2020年7月—2021年7月采用流程质控诊治的86例患者作为观察组。比较两组各急诊救治环节所用时间,两组溶栓前和溶栓15 d后NIHSS评分和MMSE评分情况,两组溶栓后出血转化、住院天数及住院期间死亡情况。结果观察组卒中小组到达时间、检查单缴费时间、血液送检时间、CT检查等待时间、家属决策时间、取药时间、办理入院时间、血液检查时间、入院之溶栓药物使用时间(DNT)均明显短于对照组,差异有统计学意义(P<0.05);溶栓15 d后观察组NIHSS评分(7.39±2.12)分明显低于对照组的(11.25±3.29)分,差异有统计学意义(t=9.082,P<0.05);溶栓15 d后观察组MMSE评分(29.12±1.49)分与对照组(28.89±1.51)分相比,差异无统计学意义(t=0.994,P>0.05);两组溶栓后出血转化和住院期间死亡情况差异无统计学意义(P>0.05);观察组住院天数(11.39±6.63)d短于对照组的(16.46±7.17)d,差异有统计学意义(t=4.761,P<0.05)。结论在急性缺血性卒中静脉溶栓治疗中采用流程质控干预能够明显缩短各救治环节所用时间,可提高救治效率,可有效减轻患者神经功能缺损情况,缩短患者住院时间,有利于患者的预后。Objective To investigate the clinical effect of process quality control in intravenous thrombolysis for acute ischemic stroke.Methods A total of 168 patients with acute ischemic stroke accepted by the hospital from June 2019 to July 2021 were selected as the subjects,and 82 patients who were not diagnosed and treated with process quality control from June 2019 to June 2020 were selected as the control group.86 patients who were diagnosed and treated by process quality control from July 2020 to July 2021 were selected as the observation group.The time spent in each emergency treatment session,the NIHSS score and MMSE score before and 15 d after thrombolysis,the hemorrhagic transformation after thrombolysis,the length of hospital stay and the death during hospitalization were compared between the two groups.Results In the observation group,the arrival time of the stroke team,the payment time of the checklist,the blood test time,the CT examination waiting time,the family decision-making time,the drug collection time,the admission time,the blood test time,and the admission time of thrombolytic drugs(DNT)were all significantly lower than those of the observation group,significantly shorter than the control group,the difference was statistically significant(P<0.05).15 d after thrombolysis,the NIHSS score of the observation group(7.39±2.12)points was significantly lower than that of the control group(11.25±3.29)points,and the difference was statistically significant(t=9.082,P<0.05).There was no statistically difference between the observation group(29.12±1.49)points and the control group(28.89±1.51)points in MMSE score 15 d after thrombolysis(t=0.994,P>0.05).There was no statistically significant difference in hemorrhagic transformation and death during hospitalization between the two groups(P>0.05).The length of hospital stay in the observation group was(11.39±6.63)d shorter than that in the control group(16.46±7.17)d,and the difference was statistically significant(t=4.761,P<0.05).Conclusion The use of process q

关 键 词：流程质控 急性缺血性卒中 静脉溶栓治疗 NIHSS评分 MMSE评分 住院天数 

分 类 号：R743[医药卫生—神经病学与精神病学]