卒中现场评估及分类转运量表对卒中患者院前分流效果和急救质量的影响  

Influence of stroke on‑site assessment and classified transport scale on prehospital shunting effect and first aid quality of stroke patients

作　　者：刘萍 敖斯斯 LIU Ping;AO Sisi(Wuhan Emergency Center,Wuhan 430060,Hubei,China)

机构地区：[1]武汉市急救中心,湖北武汉430060

出　　处：《武汉大学学报（医学版）》2024年第6期726-730,共5页Medical Journal of Wuhan University

摘　　要：目的:探究卒中现场评估及分类转运量表对卒中患者院前分流效果和急救质量的影响。方法:选取2020年1月—2021年1月期间于医院卒中中心急诊科收治的急性脑卒中患者302例为研究对象,其中以2020年1—6月期间入院的患者为对照组,以2020年7月—2021年1月期间入院的患者为观察组,两组各151例。对照组予以常规院前评估,观察组予以卒中现场评估及分类转运(FAST-ED)量表评估,比较两组院前分流效果(出诊反应时间、呼救至急救时间、呼救至入院时间),比较两组现场急救成功率、转运成功率、急诊科延续抢救成功率;比较两组的临床结局,比较两组救治成功患者治疗前、治疗后14 d神经功能、认知功能缺损情况。结果:观察组的出诊反应时间、呼救至急救时间、呼救至入院时间均较对照组明显缩短(P<0.05);观察组的现场急救成功率为99.34%(150/151),对照组为90.73%(137/151),组间比较差异有统计学意义(P<0.05);观察组转运成功率为100%(150/150),对照组为96.35%(132/137),组间比较差异具有统计学意义(P<0.05);观察组急诊科延续抢救成功率为98.67%(148/150),对照组为93.94%(124/132),组间比较差异具有统计学意义(P<0.05)。观察组的临床结局明显优于对照组(P<0.05);治疗14 d后,观察组抢救成功患者的美国国立卫生研究院卒中量表(NIHSS)评分明显低于对照组,简易智能精神状态检查量表(MMSE)评分明显高于对照组(P<0.05)。结论:FAST-ED现场评估能够明显提升卒中患者的院前分流效果,提高患者的现场、转运、延续抢救成功率,改善患者的临床结局,减轻抢救成功患者的神经功能及认知功能缺损程度。Objective:To explore the effect of stroke on‑site assessment and categorical transport scale on prehospital shunting and first aid quality in stroke patients.Methods:A total of 302 patients with acute stroke admitted to the emergency department of the stroke center of the hospital from January 2020 to January 2021 were selected as the research objects,among which the patients admitted from January to June 2020 were taken as the control group,and the patients admitted from July 2020 to January 2021 were taken as the observation group,with 151 cases in each group.The control group was given routine pre‑hospital assessment,and the observation group was given field assessment stroke triage for emergency destination(FAST‑ED)scale evaluation;pre‑hospital shunt effect(visit reaction time,call for help to first aid time,and call for help to hospital time),the success rate of first aid,transfer success rate,and emergency department continue to rescue success rate were compared between the two groups.The clinical outcomes and the neurological and cognitive deficits of the two groups were also compared before and 14 days after treatment.Results:The reaction time,the time from calling for help to first aid,and the time from calling for help to admission in the observation group were significantly shorter than those in the control group(P<0.05).The success rate of on‑site first aid of the control group was 99.34%,and that of the observation group was 90.73%,and there was a significant difference between the two groups(P<0.05).The success rate of transport was 100%(150/150)in the observation group and 96.35%(132/137)in the control group,with significant difference between the two groups(P<0.05).The success rate was 98.67%(148/150)in the observation group,which was higher than 93.94%(124/132)in the control group with significant difference(P<0.05).The clinical outcome of the observation group was significantly better than that of the control group(P<0.05).After 14 days of treatment,the national institutes of health st

关 键 词：卒中现场评估及分类转运量表 急性脑卒中 院前分流效果 临床抢救结局 

分 类 号：R743[医药卫生—神经病学与精神病学]