急性缺血性脑卒中救治流程对院内缺血性脑卒中的救治作用

目的 分析上海长海医院院内急性缺血性卒中超急性期救治情况,探讨脑卒中中心成立后对于院内卒中救治的成效。方法 自2013年9月成立脑卒中中心并执行急性缺血性卒中超急性期救治流程后,我们建立了卒中应急小组,超急性期缺血性卒中患者进入急救绿色通道,进行快速影像学评估、溶取栓小组制定救治方案、溶栓及取栓后患者进入卒中单元等治疗措施和流程。定期开展对医务人员的培训和各个科室之间的沟通交流。结果 建立应急流程后,超急性期缺血性卒中患者溶栓及取栓救治数量明显增加,从发病到呼叫会诊时间明显缩短,溶取栓人数明显增加,心内科及心胸外科患者最多见,其中房颤为最主要的危险因素。结论 超急性期救治流程建立后,院内卒中溶栓及取栓人数明显增加,其中,心内科及胸外科术后的最多见,考虑和这两个科室病种的特殊性相关(脑血管病危险因素高发科室),自从救治流程建立后,每年院内卒中溶栓及取栓的人数在不断增加,这与加强了相关科室的联系及交流相关。

Effect of rescue process of acute ischemic stroke on treating in-hospital ischemic stroke

Objective To analyze the effect of the rescue process of acute ischemic stroke in Shanghai Changhai Hospital, and to explore the effect of the process to in-hospital stroke after the establishment of stroke center. Methods Since the September 2013 establishment of the stroke center and the implementation of acute ischemic stroke in acute phase treatment process, we establish the stroke emergency teams, in patients with acute ischemic stroke into the emergency Easy Access, fast imaging evaluation, soluble thrombectomy group to develop a treatment plan, thrombolysis and thrombectomy in patients after stroke unit treatment measures and procedures. Regularly carry out training for medical staff and communication between departments. Results After the emergency procedure was established, the number of thrombolytic therapy and embolectomy was significantly increased in patients with hyperacute ischemic stroke, from onset to call consultation time was significantly shortened, the number of thrombolysis increased significantly. The most common patients were in Depatment of Cardiology and Department of thoracic surgery.Atrial fibrillation is the most important risk factor.Conclusion The acute phase treatment process after the establishment of hospital stroke solution treatment significantly increased the number of thrombectomy, the center of medicine and Department of thoracic surgery after surgery, the most common, and consider the two sections of the particularity of the disease (the high prevalence of risk factors for cerebrovascular disease).The number of in-hospital stroke patient who undergoing thrombolysis and embolectomy is increasing annually, since the stroke rescue process was established.Think about this reason is related departments communication increase.