新医学Issue(10)：702-705,4.DOI:10.3969/g.issn.0253-9802.2015.10.014
急性缺血性脑卒中 rt-PA 静脉溶栓标准化诊疗流程实施效果分析
Effect of implementing standard diagnosis and treatment workflow of rt-PA venous thrombolysis in treating acute ischemic stroke
摘要
Abstract
Objective To investigate the effect of implementation of standard diagnosis and treatment workflow of recombinant tissue-type plasminogen activator (rt-PA)venous thrombolysis upon the diagnosis, treatment and clinical efficacy in patients with acute ischemic stroke.Methods Eighty four acute ischemic stroke patients were enrolled in this study.Eight cases were assigned into the before-implementation group and 76 into the after-implementation group.Recovery rates of two groups were statistically compared.The thrombol-ysis rate after implementation was calculated.The time interval between arrival at emergent outpatient and start-ing CT/MR scan and between arrival at emergent outpatient and beginning thrombolysis therapy was statistically compared between two groups.Results Recovery rates in before-implementation group and after-implementa-tion group were (1 4.9 ±21 .4)% and (44.2 ±38.0)% with statistical significance (t =-2.1 20,P <0.05).In the after-implementation group,76 patients presented with thrombolysis indication upon emergent outpatient,eventually 55 (72.4%)of whom undergoing thrombolysis therapy.In the after-implementation group,the time interval between arrival at emergent outpatient and beginning CT/MRI scan was (38.1 ±1 9.5) min,slightly shorter compared with (30.5 ±1 5.8)min in the before-implementation group without statistical significance (P >0.05).The time interval between arrival at emergent outpatient and beginning thrombolysis therapy was (1 91 .9 ±1 93.4)min in the after-implementation group,significantly longer than (86.9 ±29.3) min in the before-implementation group (t =3.900,P <0.001 ).In the after-implementation group,the time interval between arrival at emergent outpatient and starting workflow by telephone was (1 3.1 ±21 .5) min, (1 6.1 6 ±22.6)min between arrival at emergent outpatient and consulting chief resident physician and (66.8 ±27.6)min between arriving at emergent outpatient and signing the informed consents.Conclusion Imple-menting standard diagnosis and treatment workflow of rt-PA venous thrombolysis contributes to shorten the time interval between arrival at emergent outpatient and receiving thrombolysis therapy,enhance thrombolysis oppor-tunity and improve the therapy effects.关键词
急性缺血性脑卒中/重组组织型纤溶酶原激活剂/静脉溶栓/标准化诊疗流程Key words
Acute ischemic stroke/Recombinant tissue-type plasminogen activator/Venous thrombolysis/Standard diagnosis and treatment workflow引用本文复制引用
姚麟,连晓鹏,秦冰..急性缺血性脑卒中 rt-PA 静脉溶栓标准化诊疗流程实施效果分析[J].新医学,2015,(10):702-705,4.基金项目
2014年度广东现代医院管理研究所科研立项课题《基于标准化诊疗流程的医疗质量管理模式的探索》 （）
