信息化时间追踪管理模式对急性缺血性脑卒中救治速度的影响

目的 探讨信息化时间追踪管理模式对急性缺血性脑卒中（AIS）救治速度的影响。方法 选择2016年8月至2018年6月在海军军医大学（第二军医大学）长海医院脑血管病中心接受静脉溶栓和（或）血管内治疗的AIS患者475例，分为时间追踪组（n=291）和非时间追踪组（n=184）。对比两组患者发病至入院时间（ODT）、入院至影像学检查时间（DIT）、影像学检查至静脉溶栓时间（INT）、发病至静脉溶栓时间（ONT）、影像学检查至股动脉穿刺时间（IPT）、发病至股动脉穿刺时间（OPT）、入院至静脉溶栓时间（DNT）和入院至股动脉穿刺时间（DPT）。采用Spearman相关性分析研究启动时间追踪与未启动时间追踪患者的ODT与DNT、ODT与DPT相关性。结果 在静脉溶栓患者中，时间追踪组DNT短于非时间追踪组且差异有统计学意义[27（23，36）min vs 33（23，43）min，Z=2.123，P<0.05]；未启动时间追踪患者的ODT与DNT呈负相关（r=－0.293，P=0.001），启动时间追踪患者的ODT与DNT无相关性（r=－0.034，P=0.723）。在血管内治疗患者中，时间追踪组ODT、OPT均长于非时间追踪组[246（113，431）min vs 166（82，299）min，342（211，519）min vs 277（142，406）min]，DIT短于非时间追踪组[18（14，23）min vs 26（16，34）min）]，差异均有统计学意义（Z=2.667、2.182、4.077，P均<0.05）；未启动时间追踪患者的ODT与DPT呈负相关（r=－0.234，P=0.024），启动时间追踪患者的ODT与DPT无明显相关性（r=－0.056，P=0.424）。结论 信息化时间追踪管理模式可以提高急性缺血性脑卒中救治速度，消除ODT对DNT、DPT的影响。

Effect of informationized time tracking management mode on treatment speed of acute ischemic stroke

Objective To explore the effect of informationized time tracking management mode on the speed of treatment of acute ischemic stroke (AIS). Methods From Aug. 2016 to Jun. 2018, a total of 475 AIS patients receiving intravenous thrombolysis and/or intravascular treatment in Stroke Center of Changhai Hospital of Navy Medical University (Second Military Medical University) were divided into time tracking group (n=291) and non-time tracking group (n=184). The time indicators were compared between the two groups, including onset-to-door time (ODT), door-to-imaging time (DIT), imaging-to-needle time (INT), onset-to-needle time (ONT), imaging-to-puncture time (IPT), onset-to-puncture time (OPT), door-to-needle time (DNT) and door-to-puncture time (DPT). The correlations between ODT and DNT, and ODT and DPT were analyzed using Spearman correlation analysis in the non-time tracking group and the time tracking group. Results The DNT of the patients with intravenous thrombolysis was significantly shorter in the time tracking group than that in the non-time tracking group (27[23, 36] min vs 33[23, 43] min, Z=2.123, P<0.05). There was a significant negative correlation between ODT and DNT of the patients with intravenous thrombolysis in the non-time tracking group (r=-0.293, P=0.001), while there was no correlation in the time tracking group (r=-0.034, P=0.723). The ODT and OPT of the patients with endovascular treatment were significantly longer, and DIT was significantly shorter in the time tracking group than those in the non-time tracking group (246[113, 431] min vs 166[82, 299] min, 342[211, 519] min vs 277[142, 406] min and 18[14, 23] min vs 26[16, 34] min; Z=2.667, 2.182 and 4.077, all P<0.05). There was a significant negative correlation between ODT and DPT of the patients with endovascular treatment in the non-time tracking group (r=-0.234, P=0.024), while there was no correlation between ODT and DPT in the time tracking group. (r=-0.056, P=0.424). Conclusion The informationized time tracking management mode can improve the treatment efficiency of acute ischemic stroke and eliminate the influence of ODT on DNT and DPT.