中国卒中杂志2018，Vol.13Issue(2)：127-131,5.DOI:10.3969/j.issn.1673-5765.2018.02.006
院内卒中救治绿色通道建立、优化及区域救治网络的建立
Construction and Optimization of In-hospital Stroke Fast Channel and Construction of Regional Stroke Rescue Network
摘要
Abstract
Objective In the context of current era of mechanical thrombectomy, this study is to explore how to establish acute stroke emergency system suited for local condition, make more stroke patients arrive at the qualified hospitals within the therapy time window, and increase the overall level of regional stroke rescue treatment. Methods Since 2014, the hospital and regional health administrative departments began to assist the local hospitals to make the policy and regulation of stroke rescue. The Department of Neurology of the Third Military University Affiliated First Hospital took the lead in aspect of technique, developed the training of diagnosis and treatment of stroke, provided assistance in establishing rescue workflow and assisted the collaborative hospitals to establish stroke emergency workflow and criterion. The improvement of key performance indicator (KPI) of acute ischemic stroke (AIS) care of our hospital, and change of stroke rescue level of collaborative hospitals were observed. Results (1) Establishment of stroke fast channel: the hospital director participated in the work. The department of medical affairs carried out the monitoring and coordination work. Many departments actively participated in the work, including Emergency, Neurology, Neurosurgery, Neuroimaging, Laboratory Medicine, ECG, and Nursing Security. The door-to-needle time (DNT) was shortened from 71 minutes before to 53 minutes now; the door-to-puncture time (DPT) was shortened from 104 minutes before to 82 minutes now; the door-to-revascularization time (DRT) was shortened from 144 minutes before to 117 minutes now. (2) Establishment of regional stroke rescue network: the level of AIS emergency care of our hospital got greatly improved. The total number of patients treated with IV thrombolysis and endovascular treatment increased from 7 in 2014 to 112 in 2016; the KPIs of stroke care in primary stroke center in this region also got improved significantly. Conclusion The establishment of in-hospital stroke fast channel and regional stroke rescue network can increase the level of stroke emergency care and regional stroke cure rate. It's worthwhile to be further improved and widely promoted.关键词
急性缺血性卒中/急诊救治系统/入院-静脉溶栓时间/入院-动脉穿刺时间/入院-血运重建时间Key words
Acute ischemic stroke/Emergency rescue system/Door-to-needle time/Door-to-puncture time/Door-to-revascularization time引用本文复制引用
李光建,吴敏,刘璐,陈康宁,史树贵,周振华,陈林,桂莉,翟红,肖力,吴宜虹,陈真芳..院内卒中救治绿色通道建立、优化及区域救治网络的建立[J].中国卒中杂志,2018,13(2):127-131,5.基金项目
重庆市科学技术委员会科技民生项目资助(CSTC2015shmszx120048)第三军医大学军事医学与战创伤救治临床新技术计划项目(SWH2016BZGFSBJ-01) （CSTC2015shmszx120048）
