区域一体化智慧急救系统对急诊脑卒中患者血气分析指标和凝血功能的影响  

Impact of county level integrated intelligent emergency system on the blood gas analysis in⁃dicators and coagulation function in emergency stroke patients

作　　者：滑方方 刘静[1] 黄箫琪 张笑 丁一 HUA Fangfang;LIU Jing;HUANG Xiaoqi;ZHANG Xiao;DING Yi(Emergency Medicine Department of Taihe County People's Hospital,Fuyang,Anhui,China 236000)

机构地区：[1]安徽省太和县人民医院急诊医学科,安徽阜阳236000

出　　处：《分子诊断与治疗杂志》2024年第12期2398-2401,2405,共5页Journal of Molecular Diagnostics and Therapy

基　　金：安徽省医学会急诊医学临床研究项目(Ky2021028)。

摘　　要：目的分析区域一体化智慧急救系统在急诊脑卒中患者中的应用效果。方法:选择2022年1月至2023年12月安徽省太和县人民医院120接诊的急诊脑卒中患者294例,2022年1-12月的急性脑卒中患者为对照组,2023年1-12月的急性脑卒中患者为研究组,对照组147例采用传统急救模式救治,研究组147例采用区域一体化智慧急救系统救治。比较两组的各环节救治时间[到院至影像学检查时间(DIT)、影像学检查至静脉溶栓时间(INT)、发病至到院时间(ODT)、到院至静脉溶栓时间(DNT)]、神经功能[美国国立卫生研究院卒中量表(NIHSS)评分]、预后[溶栓后7 d时格拉斯哥预后量表(GOS)评分、改良Rankin评分量表(mRS)评分≤2分的比例、出血转化率、症状性颅内出血比例]、血气分析指标[动脉二氧化碳分压(PaCO_(2))、动脉氧分压(PaO_(2))、血氧饱和度(SpO_(2))]、凝血功能[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)]。结果研究组的DIT、INT、ODT、DNT均短于对照组,差异有统计学意义(P<0.05)。溶栓后24 h,两组的NIHSS评分均小于就诊时,且研究组小于对照组,差异有统计学意义(P<0.05)。研究组的溶栓后7 d时GOS评分大于对照组,mRS评分≤2分的比例高于对照组,出血转化率低于对照组,差异有统计学意义(P<0.05),症状性颅内出血比例较对照组差异无统计学意义(P>0.05)。救治后,两组的PaCO_(2)小于救治前,且研究组小于对照组,差异有统计学意义(P<0.05)。救治后,两组的PaO_(2)、SpO_(2)、APTT、PT、TT大于救治前,且研究组大于对照组,差异有统计学意义(P<0.05)。结论区域一体化智慧急救系统能提高急诊脑卒中患者的抢救效率,缩短各环节救治时间,改善患者神经功能、预后、血气分析指标、凝血功能。Objective To observe the application effect of county level integrated intelligent emer⁃gency system in emergency stroke patients.Methods A total of 294 cases of 120 emergency stroke patients admitted to Taihe County People's Hospital of Anhui Province from January 2022 to December 2023 Patients with acute stroke from January to December 2022 were the control group,and patients with acute stroke from January to December 2023 were the study group.147 cases in the control group were treated with traditional emergency mode,and 147 cases in the study group were treated with county level integrated intelligent emer⁃gency system.The treatment time of each link[door⁃to⁃imaging time(DIT),imaging⁃to⁃needle time(INT),onset⁃to⁃door time(ODT),door⁃to⁃needle time(DNT)],neurological function[National Institutes of Health Stroke Scale(NIHSS)score],prognosis[Glasgow Outcome Scale(GOS)score was evaluated at 7 days after thrombolysis,the modified Rankin scale(mRS)score was≤2,hemorrhagic conversion rate,proportion of symptomatic intracranial hemorrhage],blood gas analysis indicators[arterial partial pressure of carbon dioxide(PaCO_(2)),arterial partial pressureof oxygen(PaO_(2)),blood oxygen saturation(SpO_(2))]and coagulation function[activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT)]of each link were compared between the two groups.Results The DIT,INT,ODT and DNT of the study group were shorter than those of the control group,and the differences were statistically significant(P<0.05).24 hours af⁃ter thrombolysis,the NIHSS scores of the two groups were lower than those at the time of admission,and the NIHSS scores of the study group were lower than those of the control group,the difference was statistically significant(P<0.05).The GOS score on the 7th day after thrombolysis in the study group was higher than that in the control group,the proportion of mRS Score≤2 was higher than that in the control group,and the hemor⁃rhagic transformation rate was lower than that in the

关 键 词：区域一体化智慧急救系统 急诊 脑卒中 

分 类 号：R743.3[医药卫生—神经病学与精神病学]