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“EMS转运联合绿色通道模式”下对急性缺血性脑卒中患者救治时间和临床预后分析

Analysis of treatment time and clinical prognosis of patients with acute ischemic stroke under “EMS transport combined with green channel mode”

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【作者】 杨增珍张亚锋汤邢贺蕾郭建辉贺婵婵李珊杜培培

【Author】 YANG Zengzhen;ZHANG Yafeng;TANG Xing;HE Lei;GUO Jianhui;HE Chanchan;LI Shan;DU Peipei;120 Emergency Command Center in Rugao City;Xianyang Hospital of Yan’an University;Rugao Hospital of Shenzhen Jingcheng Medical Group;

【通讯作者】 杜培培;

【机构】 如皋市120急救指挥中心延安大学咸阳医院深圳精诚医疗集团如皋医院

【摘要】 目的 探讨院前急救医疗服务(emergency medical servicen,EMS)转运联合绿色通道对急性缺血性脑卒中(acute ischemic stroke, AIS)患者静脉溶栓救治时间、救治效果及预后的影响。方法 回顾性分析如皋市4家医院自2021年7月至2022年7月救治的205例接受静脉溶栓的AIS患者作为研究对象。将其按照院前急救方式进行分组,自行入院的患者为对照组(104例),EMS转运联合绿色通道的患者为观察组(101例)。比较两组一般资料、救治时间(ODT、DTC、DNT、OTN)、救治效果(△NIHSS评分、平均住院日)、3个月预后(无显著后遗症、轻度功能障、遗留明显残疾、死亡)。结果 两组一般资料比较,差异无统计学意义(P>0.05)。在救治时间方面,两组ODT、DTC、DNT、OTN相比较,差异有统计学意义(P<0.05),观察组时间更短。在救治效果方面,观察组△NIHSS评分更高、平均住院日更短,差异有统计学意义(P<0.05)。在预后方面,两组患者3个月内死亡比率进行比较,差异无统计学意义(P>0.05);观察组无显著后遗症、遗留明显残疾例数多于对照组,但在轻度功能障碍例数少于对照组,差异均有统计学意义(P<0.05)。结论 AIS患者进行EMS转运联合绿色通道救治,可有效地缩短ODT、DTC、DNT、OTN时间,降低平均住院日,改善临床预后。

【Abstract】 Objective To investigate the effects of emergency medical servicen(EMS)transport combined with green channel on the treatment time, treatment effect and prognosis of patients with acute ischemic stroke(AIS).Methods 205 AIS patients treated by 4 hospitals in Rugao City from July 2021 to July 2022 were analyzed retrospectively. The patients were divided into three groups according to pre-hospital emergency treatment. The self-admitted patients were the control group(104 cases), and the patients with EMS transport combined with green channel were the observation group(101 cases). The two groups were compared for general data, treatment time(ODT, DTC, DNT, OTN), treatment effect (△NIHSS score, mean length of stay), and 3-month prognosis(no significant sequelae, mild functional impairment, significant remaining disability, and death).Results There was no significant difference in general data between the two groups(P>0. 05). In terms of treatment time, ODT, DTC, DNT and OTN were significantly different between the two groups(P<0. 05), and the time in the observation group was shorter. In terms of treatment effect, the observation group had higher △NIHSS score and shorter average hospital stay, and the difference was statistically significant(P<0. 05). In terms of prognosis, there was no significant difference in the death rate within 3 months between the two groups(P>0. 05). The number of cases with no significant sequelae and significant disability in the observation group was more than that in the control group, but the number of cases with mild dysfunction was less than that in the control group, and the differences were statistically significant(P<0. 05).Conclusion EMS transport combined with green channel treatment for AIS patients can effectively shorten ODT, DTC, DNT and OTN time, reduce the average hospital stay, and improve the clinical prognosis.

【关键词】 EMS转运绿色通道AIS静脉溶栓
【Key words】 EMS transportGreen channelAISIntravenous thrombolysis
  • 【文献出处】 延安大学学报(医学科学版) ,Journal of Yan’an University(Medical Science Edition) , 编辑部邮箱 ,2023年04期
  • 【分类号】R743.3
  • 【下载频次】66
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