县域医院卒中绿色通道优化对急性缺血性卒中救治效率的影响  

Impact of optimizing stroke green channel on treatment efficiency of acute ischemic stroke treatment efficiency in a county hospital

作　　者：王耀 史雷 李光布 朱启云 吴晓强 卢茂林 林海洋 戚伟 高伟[4] 周瑞银 陆启凤 吴宝东[1] WANG Yao;SHI Lei;LI Guangbu;ZHU Qiyun;WU Xiaoqiang;LU Maolin;LIN Haiyang;QI Wei;GAO Wei;ZHOU Ruiyin;LU Qifeng;WU Baodong(Stroke Center,Sixian People’s Hospital,Suzhou 234300,Anhui,China;Department of Emergency,Sixian People’s Hospital,Suzhou 234300,Anhui,China;Department of Radiology,Sixian People’s Hospital,Suzhou 234300,Anhui,China;Department of Laboratory,Sixian People’s Hospital,Suzhou 234300,Anhui,China;Angiosuite room,Sixian People’s Hospital,Suzhou 234300,Anhui,China;Intensive Care Unit,Sixian People’s Hospital,Suzhou 234300,Anhui,China)

机构地区：[1]安徽省宿州市泗县人民医院卒中中心,宿州234300 [2]安徽省宿州市泗县人民医院急诊科,宿州234300 [3]安徽省宿州市泗县人民医院影像科,宿州234300 [4]安徽省宿州市泗县人民医院检验科,宿州234300 [5]安徽省宿州市泗县人民医院导管室,宿州234300 [6]安徽省宿州市泗县人民医院危重症医学科,宿州234300

出　　处：《中国临床医学》2024年第6期971-976,共6页Chinese Journal of Clinical Medicine

基　　金：2022年度宿州市卫生健康科研项目(SZWJ2022a010).

摘　　要：目的 探讨县域医院卒中绿色通道优化对急性缺血性卒中救治效率的影响。方法 回顾性分析泗县人民医院2020年5月至2021年4月(绿色通道优化前)和2021年5月至2022年4月(绿色通道优化后)急诊卒中绿色通道诊疗数据,比较卒中绿色通道优化前后,静脉溶栓(intravenous thrombolysis, IVT)患者比例、机械取栓(mechanical thrombectomy, MT)患者比例、患者就诊到接受IVT的时间(door-to-needle time, DNT)、就诊到穿刺的时间(door-topuncture time, DPT)以及患者治疗后3个月的改良Rankin量表(modified Rankin scale, mRS)评分。结果 在绿色通道优化前、后1年内,缺血性卒中患者急性就诊人数分别为3 143例和2 623例。优化前接受IVT、MT者分别84、51例。绿色通道优化后,IVT(n=215)及MT(n=103)患者比例升高,DNT和DPT缩短(P<0.000 1);MT患者出院后3个月mRS评分为0~2分者占比升高(46/99 vs 13/46,P=0.038)。结论 泗县人民医院优化绿色通道后,卒中救治效率提高,患者预后改善,效果显著。Objective To evaluate the impact of optimizing the stroke green channel on the efficiency of acute ischemic stroke management in a county hospital.Methods A retrospective analysis of the emergency stroke green channel treatment data from Sixian People’s Hospital from May 2020 to April 2021(before optimization of the green channel)and from May 2021 to April 2022(after optimization of the green channel)was conducted.The rates of intravenous thrombolysis(IVT)and mechanical thrombectomy(MT)patients,as well as door-to-needle time(DNT),door-to-puncture time(DPT),and the modified Rankin scale(mRS)scores of patients three months post-treatment before and after the optimization of the stroke green channel were compared.Results Within one year before and after optimization of the green channel,the number of acute visits for ischemic stroke was 3143 and 2623,respectively.Before optimization,84 and 51 underwent IVT and MT,respectively.After optimization of the green channel,the ratios of patients underwent IVT(n=215)and MT(n=103)significantly increased,and both DNT and DPT were significantly shortened(P<0.0001);the proportion of MT patients with an mRS score of 0-2 at 3 months post-discharge significantly increased(46/99 vs 13/46,P=0.038).Conclusion After optimizing the green channel at Sixian People’s Hospital,the efficiency of stroke treatment has significantly improved,and the patients’prognosis improved.

关 键 词：缺血性卒中 绿色通道 优化 静脉溶栓 机械取栓 

分 类 号：R459.7[医药卫生—急诊医学]