基于MBO的急诊绿色通道策略优化方案在AIS患者抢救中的应用  

Application of optimization plan for emergency green channel strategy based on MBO in the rescue of AIS patients

作　　者：容桂荣[1] 廖春燕[1] 李浩[1] 张莉莉[1] 唐瑶 王振冉[1] RONG Guirong;LIAO Chunyan;LI Hao;ZHANG Lili;TANG Yao;WANG Zhenran(Affiliated Hospital of Guilin Medical University,Guilin 541001,China)

机构地区：[1]桂林医学院附属医院,桂林541001

出　　处：《华夏医学》2024年第3期192-197,共6页Acta Medicinae Sinica

基　　金：桂林市科学研究与技术开发计划项目(20190218-5-8);桂林医学院大学生创新创业训练计划项目(s202110601151)。

摘　　要：目的探讨基于目标管理理论(MBO)的急诊绿色通道策略优化方案在脑卒中(AIS)患者抢救中的应用效果。方法选取桂林市某三级甲等医院2022年1月至12月收治的急诊绿色通道入院AIS患者139例为观察组,2021年1月至12月收治的同类患者151例为对照组。观察组采用基于MBO的AIS急诊绿色通道策略优化方案,对照组采用常规急诊绿色通道抢救方案,比较两组的再灌注率、神经功能缺损NIHSS评分、抢救时间、并发症(脑出血、消化道出血)发生率。结果救治后,观察组的血管再灌注率86.33%高于对照组的58.28%,差异有统计学意义(P<0.05);观察组的出院前NIHSS评分低于对照组(P<0.05);观察组自急诊科到CT室平均时间、自CTA+CTP结束到结果报告平均时间均短于对照组(P<0.05);治疗期间,观察组的消化道出血发生率2.16%低于对照组的5.30%(P<0.05);两组脑出血发生率无统计学差异(P>0.05)。结论基于MBO的AIS急诊绿色通道策略优化方案能提高患者再灌注率,缩短术前诊断时间,减少消化道出血并发症,提高治疗效果。Objective To explore the application effect of optimization plan for emergency green channel strategy based on management by objectives(MBO)theory in the rescue of patients with acute ischemic stroke(AIS).Methods 139 AIS patients who were admitted through the emergency green channel between January to December 2022 from a tertiary Grade A hospital in Guilin were as the observation group.And 151 patients of same type from January to December 2021 were selected as the control group.The control group were received the conventional emergency green channel method.The observation group were received the optimization plan for the green channel strategy for stroke emergency based on the goal management theory.The perfusion rate,the NIHSS score of nerve function defects,the average time from the emergency department and the incidence of complications of cerebral hemorrhage and gastrointestinal bleeding during treatment were compared between two groups.Results After treatment,the vascular reperfusion rate in the observation group was 86.33%higher than that of 58.28%in the control group,showing a statistically significant difference(P<0.05).The NIHSS score before discharge in the observation group was lower than that in the control(P<0.05).The average time from the emergency department to the CT room and from the end of CTA+CTP to the result report in the observation group were shorter than those in the control group(P<0.05).During the treatment period,the incidence of gastrointestinal bleeding in the observation group was 2.16%lower than that in the control group,which was 5.30%(P<0.05).There was no statistical difference in the incidence of ICH between the two groups(P>0.05).Conclusion The optimization scheme of the green channel strategy for stroke emergency based on MBO theory can improve the patients′perfusion rate,shorten the preoperative diagnosis time,reduce complications of gastrointestinal bleeding,and improve the treatment effect.

关 键 词：急性缺血性脑卒中 目标管理理论 急诊绿色通道策略优化方案 再灌注 时间管理 

分 类 号：R473.5[医药卫生—护理学]