眼-脑卒中“双轨并行”治疗在视网膜中央动脉阻塞患者溶栓中的应用  

Application of"dual-track parallel"treatment of oculo cerebral stroke in thrombolysis for patients with central retinal artery occlusion

作　　者：赵楠 吴雅琼 杨文艺[1] 孙冉[1] ZHAO Nan;WU Yaqiong;YANG Wenyi;SUN Ran(Department of Ophthalmology,Beijing Xuan Wu Hospital,Capital Medical University,Biig100053,China)

机构地区：[1]首都医科大学宣武医院眼科,北京100053

出　　处：《暨南大学学报（自然科学与医学版）》2023年第3期267-273,共7页Journal of Jinan University(Natural Science & Medicine Edition)

基　　金：首都临床特色应用研究与成果推广项目(Z171100001017029)。

摘　　要：目的:探讨眼-脑卒中绿色通道“双轨并行”治疗流程在视网膜中央动脉阻塞(CRAO)患者中超选择溶栓治疗的应用效果。方法:实行眼-脑卒中绿色通道“双轨并行”治疗流程;选取流程优化前42名CRAO患者为对照组,流程优化后38名CRAO患者为观察组,比较两组患者治疗有效率及黄斑中心凹厚度,患者到院至用药时间(DNT)及各关键环节时间。结果:观察组治疗有效率比对照组高23.7%,两组有效率差异有统计学意义(P<0.05);与对照组相比,观察组术后1周黄斑中心凹厚度更薄,差异具有统计学意义(P<0.05);观察组比对照组DNT中位数缩短220 min,差异有统计学意义(P<0.05);观察组从开具医嘱到完成眼底荧光血管造影时间、抽血结束至化验回报时间、接诊至完成CT时间、决策时间及手术安排时间比对照组均得到缩短,差异有统计学意义(P<0.01)。结论:实行眼-脑卒中绿色通道“双轨并行”治疗流程优化效果明显,缩短了DNT及各关键环节时间,提高CRAO患者治疗有效率。Objective:This study aims to investigate the application effect of the"dual-track parallel"treatment process of the oculo-cerebral stroke green channel in superselective thrombolysis for patients with central retinal artery occlusion(CRAO).Methods:The"dual-track"treatment process was implemented,and 42 CRAO patients were selected as the control group,while 38 CRAO patients were selected as the observation group.After the two groups,the treatment response rate,macular foveal thickness,door-to-needle time(DNT),and key links were compared.Results:The treatment response rate was 23.7%higher than the control group,and there was a significant difference between the two groups(P<0.05).Compared with the control group,the observation group had a thinner macular foveal thickness one week after surgery,and the difference between the two groups was statistically significant(P<0.05).The median DNT was 220 minutes shorter than the control group,and there was a significant difference between the two groups(P<0.05).The observation group shortened the time from the medical orders to the fundus fluorescence angiography,the time to the return of the blood drawing,the time to the completion of the CT,the decision-making time,and the surgical arrangement time than that of the control group.There were significant differences between the two groups(P<0.O1).Conclusion:The optimization of the treatment process by dual-track parallel implementing of the oculo-cerebral stroke green channel is effective,which can reduce the DNT and the time spent in critical points and improve the treatment response rate in patients with CRAO.

关 键 词：视网膜中央动脉阻塞 超选择眼动脉溶栓 双轨绿色通道 流程优化 

分 类 号：R774.1[医药卫生—眼科]