Application effect of mobile stroke units in patients with acute ischemic stroke undergoing intravenous thrombolysis
江松华 1王英 1刘丽娜 1郭修凯 1于淼2
扫码查看
点击上方二维码区域，可以放大扫码查看
作者信息
1. 山东省聊城市人民医院脑科医院急诊科,山东聊城 252000
2. 山东省聊城市人民医院脑科医院监护室,山东聊城 252000
折叠
摘要
目的 探讨移动卒中单元在急性缺血性脑卒中患者静脉溶栓中的应用效果.方法 选取2021 年3 月至9 月聊城市人民医院脑科医院卒中中心收治的98 例急性缺血性脑卒中静脉溶栓患者作为研究对象,将其分为观察组(43 例)和对照组(55 例),应用移动卒中单元进行静脉溶栓的患者为观察组,使用传统溶栓模式进行静脉溶栓的患者为对照组.比较两组患者静脉溶栓流程中各时间节点:入院/上车至静脉溶栓时间、发病至CT 检查完成时间、发病至静脉溶栓时间、呼叫120 至静脉溶栓时间,两组患者静脉溶栓后7、14 d 的美国国立卫生院卒中量表(NIHSS)评分,溶栓后90 d 的改良R ankin 量表(mRS)评分,溶栓后90 d 神经功能转归良好(mRS 评分0～2 分)率.结果 观察组患者入院/上车至静脉溶栓时间、发病至CT检查时间、发病至静脉溶栓时间和呼叫120 至静脉溶栓时间均短于对照组,差异有统计学意义(P＜0.05).两组患者静脉溶栓后7、14 d 的NIHSS 评分均低于本组溶栓前,差异有统计学意义(P＜0.05);对照组静脉溶栓后14 d 的NIHSS 评分与溶栓后7d 比较,差异无统计学意义(P＞0.05),观察组患者静脉溶栓后14 d 的NIHSS 评分低于本组溶栓后7 d,低于对照组溶栓后14 d,差异有统计学意义(P＜0.05).两组患者溶栓后90 d 的mRs 评分均低于本组溶栓前,差异有统计学差异(P＜0.05).两组患者静脉溶栓后90 d 的mRs 评分、功能转归良好率(mRs 评分0～2 分)比较,差异无统计学意义(P＞0.05).结论 运用移动卒中单元对急性缺血性脑卒中患者进行救治,可以明显缩短入院/上车至静脉溶栓时间、发病至CT检查时间、发病至静脉溶栓时间以及呼叫至静脉溶栓时间,提高救治率,改善患者症状,但对于急性脑卒中患者静脉溶栓的救治效果还需要多中心大样本研究进一步验证.
Abstract
Objective To investigate the application effect of mobile stroke units in patients with acute ischemic stroke un-dergoing intravenous thrombolysis.Methods A total of 98 patients with acute ischemic stroke undergoing intravenous thrombolysis admitted to the Stroke Center of Liaocheng People's Hospital Brain Hospital from March to September 2021 were selected as the research subjects.They were divided into observation group(43 cases)and control group(55 cases).The observation group received intravenous thrombolysis using a mobile stroke unit,while the control group received traditional thrombolysis.Various time points during the thrombolysis process were compared between the two groups:time from admission/ambulance arrival to intravenous thrombolysis,time from onset to completion of CT scan,time from onset to intravenous thrombolysis,and time from calling 120 to intravenous thrombolysis.National Institutes of Health stroke scale(NIHSS)scores were assessed for both groups at 7 and 14 days after thrombolysis,and modified Rankin scale(mRS)scores were evaluated at 90 days after thrombolysis,along with the rate of favorable neurological outcome(mRS score 0-2 point).Results The times from admission/ambulance arrival to thrombolysis initiation,from symptom onset to CT examination,from symptom onset to thrombolysis initiation,and from emer-gency call 120 to thrombolysis initiation in the observation group were shorter than those in the control group,with statistical significances(P＜0.05).NIHSS scores at 7 and 14 days post-thrombolysis in both groups were lower than their respective scores pre-thrombolysis,with statistical significance(P＜0.05).In the control group,the NIHSS score at 14 days post-thrombolysis was not significantly different from that at 7 days post-thrombolysis(P＞0.05),while in the observa-tion group,the NIHSS score at 14 days post-thrombolysis was lower than that at 7 days post-thrombolysis and lower than the NIHSS score at 14 days post-thrombolysis in the control group,with statistical significances(P＜0.05).The mRS scores at 90 days post-thrombolysis in both groups were lower than their respective scores pre-thrombolysis,with statistical signifi-cances(P＜0.05).The comparison of mRS scores and the rate of favorable neurological outcomes(mRS scores 0-2 point)at 90 days post-thrombolysis between the two groups showed no statistically significant differences(P＞0.05).Conclusion The utilization of mobile stroke units for the management of patients with acute ischemic stroke undergoing intravenous thrombolysis significantly reduced the time from admission/ambulance arrival to thrombolysis initiation,time from symptom onset to CT examination,time from symptom onset to thrombolysis initiation,and time from emergency call to thrombolysis initiation.This approach improved the treatment rate and alleviated patient symptoms.However,the efficacy of intravenous thrombolysis for acute ischemic stroke patients requires further validation through large-scale multicenter studies.
维普
万方数据