摘要
目的 研究实施院前-院内医疗联动体系对缺血性脑卒中患者急救的效果.方法 以2022年1月1日至2023年3月31日,经院前-院内医疗联动体系入住上海市松江区中心医院确诊为急性缺血性脑卒中并行溶栓治疗的患者为观察组(n=117),另外以2021年1月1日至2021年3月31日常规急救治疗下的脑卒中患者为对照组(n=109).比较两组患者识别时间、患者运送时间、院前院内衔接时间、就诊至开始溶栓时间(DNT)、住院时间、并发症发生率、死亡情况、Barthel指数、N1HSS评分.结果 观察组院前院内衔接时间、DNT时间、住院时间短于对照组,差异有统计学意义(P＜0.05);对照组患者并发症总发生率高于观察组,差异有统计学意义(44.95％vs 20.51％,χ2=15.415,P＜0.05);治疗后,观察组Barthel指数高于对照组,NIHSS评分低于对照组,差异有统计学意义(P＜0.05).结论 院前-院内医疗联动体系在缺血性脑卒中患者急救中的应用效果显著,可缩短DNT时间,减少并发症同时能够有效提升患者的日常生活能力和神经功能恢复.
Abstract
Objective To study the application effect of the pre-hospital and in-hospital medical linkage system in emergency care of ischemic stroke patients.Methods The observation group consisted of patients diagnosed with acute ischemic stroke and treated with thrombolysis through the pre-hospital and in-hospital medical linkage system from January 1,2022 to March 31,2023(n=117),and the control group consisted of stroke patients under routine emergency treatment from January 1,2021 to March 31,2021(n=109).The patient identification time,patient transport time,pre-hospital to in-hospital time,door to needle time(DNT),hospital stay,incidence of complications,mortality,Barthel index,and NIHSS score were compared between two groups.Results Compared with the control group,the observation group had shorter pre-hospital and in-hospital transition time,DNT,and hospital stay(P＜0.05).The total incidence of complications in the control group was higher than that in the observation group(44.95％vs 20.51％,χ2=15.415,P＜0.05).After treatment,the Barthel index of the observation group was higher than that of the control group,and the NIHSS score was lower than that of the control group,with statistical significance(P＜0.05).Conclusion The application of pre-hospital and in-hospital linkage system in emergency care of ischemic stroke patients has a significant effect,which can shorten DNT,reduce complications,and effectively improve patients'daily living ability and neurological function recovery.
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