基于"浙里急救系统"优化的院前院内衔接流程在急性缺血性脑卒中溶栓患者中的应用研究OA

Objective To analyze the impact of the optimized emergency thrombolysis process based on the"Zhejiang Emergency System"on the emergency treatment effect of patients with acute ischemic stroke.Methods A historical control study was conducted.A total of 20 patients with acute ischemic stroke admitted to the department of emergency medicine of Lanxi People's Hospital from August 2023 to January 2024(before process optimization)were selected as the control group and treated with the conventional thrombolysis process.A total of 22 patients with acute ischemic stroke admitted to the hospital from February 2024 to July 2024(after process optimization)were selected as the observation group and received the optimized thrombolysis process based on the"Zhejiang Emergency System".The one-click call ratio,the proportion of pre-hospital blood collection completion,the proportion of medical orders issued before arrival at the emergency department,the time from admission to blood collection completion,the time from admission to blood routine examination completion,time from admission to completion of computed tomography(CT),the time from admission to consultation,and the door-to-needle time(DNT)were compared between the two groups.At the same time,the differences in the National Institutes of Health Stroke Scale(NIHSS)before and after thrombolysis,the NIHSS scores 7 days after thrombolysis,the modified Rankin scale(mRS)at discharge,and the incidence of complications were compared between the two groups.Results The one-click call ratio,the proportion of pre-hospital blood collection completion,and the proportion of medical orders issued before arrival at the emergency department in the observation group were significantly higher than those in the control group(77.27%vs.0.00%,40.91%vs.5.00%,54.55%vs.15.00%,all P<0.05);the time from admission to blood collection completion,the time from admission to blood routine examination completion,the time from admission to CT completion,the time from admission to consultation,and the DNT were significantly shorter in the observation group than in the control group[time from admission to blood collection completion(minutes):3.55±2.84 vs.6.20±3.07,time from admission to blood routine examination completion(minutes):12.91±2.31 vs.19.90±4.99,time from admission to CT completion(minutes):12.68±4.75 vs.16.65±4.89,time from admission to consultation(minutes):4.68±4.35 vs.22.00±6.51,DNT(minutes):31.91±4.50 vs.41.15±7.90,all P<0.05].There were no statistically significant differences in the NIHSS scores before thrombolysis,the mRS scores at admission,the NIHSS scores after thrombolysis,the NIHSS scores 7 days after thrombolysis,the mRS scores at discharge,and the incidence of complications between the two groups(all P>0.05).Conclusion The implementation of the optimized pre-hospital and in-hospital linkage emergency thrombolysis process based on the"Zhejiang Emergency System"can reduce the time consumption in each link,shorten the DNT,and show a trend of improving the therapeutic effect,which is worthy of clinical promotion and application.