缺血性脑卒中患者血管内治疗院内延迟现状及对策研究

发布时间：2018-03-24 03:09

本文选题：脑缺血　切入点：卒中　出处：《中国全科医学》2016年19期

【摘要】：背景对急性缺血性脑卒中的适宜患者采取血管内治疗具有临床疗效,但这一治疗方法受时间窗限制。目的通过对缺血性脑卒中患者血管内治疗流程现状进行调查,分析产生院内延迟的原因,以提出相应的解决措施。方法采用自行设计的《某三甲医院缺血性脑卒中血管内治疗流程调查表》,对2014年11月—2015年4月在某三甲医院接受血管内治疗的缺血性脑卒中患者32例进行跟踪调查,内容包括患者的一般资料、临床特征、到达急诊-开始股动脉穿刺的各环节时间及流程中影响院内总时间关键事件的记录。结果 32例患者到达急诊-开始股动脉穿刺的平均时间为(171.8±52.5)min,与90 min的国际标准时间比较差异有统计学意义(P0.05)。其中首先呼叫动脉溶栓组医师与首先呼叫静脉溶栓组医师患者到达急诊-获得动脉溶栓组医师会诊的平均时间分别为(11.7±6.8)、(66.9±53.2)min,到达急诊-开始股动脉穿刺的平均时间分别为(143.9±26.1)、(199.6±58.0)min;在CT之前进行心电图检查与在CT之后进行心电图检查患者到达急诊-到达CT室的平均时间分别为(63.1±47.3)、(31.9±12.3)min。结论缺血性脑卒中患者血管内治疗院内延迟现象严重,医院应完善脑卒中组织化管理的相关政策与制度,不断改进绿色通道质量控制机制,以缩短院内延迟时间。
[Abstract]:Background Endovascular therapy for patients with acute ischemic stroke has clinical efficacy, but this treatment is limited by time window. Objective to investigate the current status of endovascular treatment process in patients with acute ischemic stroke. Analysis of the reasons for the delay in the hospital, In order to put forward the corresponding solutions. Methods using the self-designed questionnaire on the intravascular treatment process of ischemic stroke in a third class hospital, the ischemic brain treated in a third class hospital from November 2014 to April 2015 was studied. 32 patients with stroke were followed up. The contents include the general information of the patients, clinical features, The critical events affecting the total time in the hospital were recorded. Results the average arrival time of 32 patients was 171.8 卤52.5 minutes, and the international standard was 90 min. There was significant difference in the quasi time between the two groups (P 0.05). The average time for the first call to the arterial thrombolytic group and the first call for the venous thrombolytic group was 11.7 卤6.8 卤66.9 卤53.2 minutes, respectively, for the emergency-to-patient consultation in the arterial thrombolytic group, which was 66.9 卤53.2 minutes, respectively, and the average time to reach the emergency department was 66.9 卤53.2 minutes. -the average time to start femoral artery puncture was 199.6 卤58.0 minutes before CT and 63.1 卤47.3 卤12.3 minutes before CT and after CT, respectively. Conclusion Ischemic stroke patients have an average time of 31.9 卤12.3 minutes. [WT5HZ] [WT5BZ] [WT5BZ] [WT5BZ] [WT5BZ] [WT5BZ] [WT5BZ] the average time for the onset of femoral artery puncture is 199.6 卤58.0 min. The phenomenon of hospital delay in endovascular treatment was serious. The hospital should perfect the relevant policies and regulations of the organized management of stroke, improve the quality control mechanism of green channel continuously, so as to shorten the delay time in hospital.
【作者单位】：首都医科大学卫生管理与教育学院;首都医科大学宣武医院护理部;山东大学齐鲁医院神经内科;首都医科大学科研处;首都医科大学宣武医院神经内科;北京清华长庚医院神经外科;首都医科大学宣武医院神经外科;
【基金】：首都市民健康项目培育(Z151100003915088)
【分类号】：R743.3

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