优化溶栓流程对轻型急性缺血性卒中院内延误及预后的影响

目的分析优化溶栓流程对轻型急性缺血性卒中患者院内延误及预后的影响。方法回顾性收集秦皇岛市第一医院2015年7月-2017年6月行静脉溶栓治疗的轻型缺血性卒中患者资料。按照流程优化时间前后,分为优化组和对照组。比较两组入院到溶栓时间(door to needle time,DNT)、溶栓后7 d NIHSS评分和溶栓后3个月mRS评分。结果共纳入57例轻型缺血性卒中患者,平均年龄61.7±5.4岁,男性44例(77.2%)。其中对照组24例,优化组33例。两组患者一般资料比较差异无统计学意义。与对照组比较,优化组DNT缩短(68.7±19.1 vs 88.8±23.1 min,P=0.001),DNT≤60 min的患者比例更高(42.4%vs 12.5%,P=0.015);溶栓治疗后3个月mRS评分更低[0(0～0.5)vs 0.5(0～2),P=0.017],良好预后(mRS评分≤1分)患者比例更高(87.9%vs 62.5%,P=0.024)。结论优化溶栓流程可以缩短轻型急性缺血性卒中患者的DNT,提高DNT≤60 min达标率,改善患者3个月预后。

Effect of Optimized Thrombolysis Treatment Workflow on In-hospital Delay and Prognosis in Acute Mild Ischemic Stroke

Objective To investigate the effect of optimized thrombolysis treatment workflow on door
to needle time (DNT) and prognosis in acute mild ischemic stroke patients with intravenous
thrombolysis.
Methods Data of mild ischemic stroke patients receiving intravenous thrombolysis from July
2015 to June 2017 in the First Qinhuangdao Hospital were retrospectively collected. According to
whether thrombolysis treatment workflow was optimized or not, all patients were divided into the
optimization group and the control group. Door to needle time (DNT), NIHSS score at 7 days and
mRS score at 3 months after thrombolysis of two groups were compared.
Results A total of 57 mild ischemic stroke patients were included, with a mean age of 61.7±5.4
years old and 44 males (77.2%). There were 33 patients in optimization group and 24 patients in
control group. The general information had no statistical difference between the two groups. DNT
was shorter (68.7±19.1 vs 88.8±23.1 min, P =0.001), the percentage of patients with DNT ≤60 min
was higher (42.4% vs 12.5%, P =0.015), the mRS score at 3 months was lower [0 (0-0.5) vs 0.5 (0-
2), P =0.017], and the rate of patients with mRS score ≤1 at 3 months was higher (87.9% vs 62.5%,
P =0.024) in optimization group, compared with that in control group.
Conclusions The optimized thrombolysis treatment workflow can shorten DNT, improve the rate
of DNT ≤60 min, and improve 90-day prognosis in patients with acute mild ischemic stroke.