PDCA循环模式在DSA引导下行机械取栓治疗脑卒中患者中的应用  

The application of PDCA circulation mode in mechanical thrombectomy under DSA guidance for the treatment of cerebral infarction patients

作　　者：王学芹 高洁雅 马蓓蓓 吴冠会[2] WANG Xueqin;GAO Jieya;MA Beibei;WU Guanhui(Department of Interventional Radiology,First Affiliated Hospital of Nanjing Medical University,Nanjing 210000,China;Department of Neurology,Suzhou Municipal Hospital,Suzhou 215008,China)

机构地区：[1]南京医科大学第一附属医院介入放射科,江苏南京210000 [2]江苏省苏州市立医院神经内科,江苏苏州215008

出　　处：《医学影像学杂志》2024年第6期18-21,共4页Journal of Medical Imaging

基　　金：江苏省高层次卫生人才“六个一工程”拔尖人才科研项目(编号:LGY2019015)。

摘　　要：目的探讨PDCA循环模式在数字减影血管造影(DSA)引导下行机械取栓治疗脑卒中患者中的应用效果。方法选取50例脑卒中患者作为观察组,行PDCA循环模式下DSA引导机械取栓,另选取50例脑卒中患者作为对照组,对照组患者均完成常规DSA引导下机械取栓治疗。比较两组患者取栓治疗后血管再通率,取栓治疗前、术后7 d神经功能[美国国立卫生研究院卒中量表(NIHSS)评分],术后90 d功能恢复情况[改良Rankin量表(mRs)评分],统计并发症。结果观察组术后血管再通率高于对照组,差异有统计学意义(P<0.05)。治疗前,两组NIHSS评分比较,差异无统计学意义(P>0.05);术后7 d,两组NIHSS评分降低,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组术后90 d功能恢复情况优于对照组,差异有统计学意义(P<0.05)。观察组术后出血转化、穿刺点渗血发生率低于对照组,差异有统计学意义(P<0.05)。结论PDCA循环模式在DSA引导下行机械取栓治疗脑卒中患者中的应用效果理想,可提高血管再通率、促进神经功能恢复,且能增加取栓治疗的安全性,减少相关并发症的发生。Objective To explore the application effect of PDCA circulation mode in the mechanical thrombectomy guided by digital subtraction angiography(DSA)for the treatment of cerebral infarction patients.Method A longitudinal controlled study was conducted,selecting 50 patients with cerebral infarction admitted to the hospital from October 2022 to October 2023 as the study group.DSA-guided mechanical thrombectomy under PDCA cycle mode was planned to be performed.In addition,the data of 50 patients with cerebral infarction admitted from September 2021 to September 2022 were collected as the control group.All patients in the control group were completed mechanical thrombectomy under routine DSA guidance.The vascular recanalization rate between two groups of patients after thrombectomy,neurological function before and 7 days after thrombectomy[National Institutes of Health Stroke Scale(NIHSS)score],functional recovery 90 days after surgery[Modified Rankin Scale(mRs)score]were compared,and complications were calculated.Result The postoperative vascular recanalization rate in the study group was higher than that in the control group(P<0.05).Before treatment,there was no statistical significant difference in NIHSS scores between the two groups(P>0.05).7 days after surgery,the NIHSS scores of the two groups decreased,and the study group was lower than the control group(P<0.05).The functional recovery of the study group after 90 days of surgery was better than that of the control group(P<0.05).The incidence of postoperative bleeding transformation and puncture point bleeding in the study group was lower than that in the control group(P<0.05).Conclusion The application of PDCA circulation mode in DSA-guided mechanical thrombectomy for the treatment of cerebral infarction patients has an ideal effect,which can improve vascular recanalization rate,promote neurological function recovery,increase the safety of thrombectomy treatment,and reduce the occurrence of related complications.

关 键 词：脑卒中 机械取栓 数字减影血管造影 PDCA循环 血管再通 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R815[医药卫生—临床医学]