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| 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 |
| 沈红健1,邢鹏飞1,张永鑫1,吴涛1,张永巍1,柯骏2,刘建民1,杨鹏飞1*,邓本强1* |
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(1. 海军军医大学(第二军医大学)长海医院脑血管病中心, 上海 200433;
2. 海军军医大学(第二军医大学)护理学院, 上海 200433
*通信作者) |
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| 摘要: |
| 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。 |
| 关键词: 急性缺血性脑卒中 时间追踪 信息化 静脉溶栓疗法 血管内治疗 |
| DOI：10.16781/j.0258-879x.2018.09.0977 |
| 投稿时间：2018-07-29修订日期：2018-08-19 |
| 基金项目:上海市科技创新行动计划重点项目（14401970304），上海申康发展中心临床管理优化项目（SHDC12017609）. |
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| Effect of informationized time tracking management mode on treatment speed of acute ischemic stroke |
| SHEN Hong-jian1,XING Peng-fei1,ZHANG Yong-xin1,WU Tao1,ZHANG Yong-wei1,KE Jun2,LIU Jian-min1,YANG Peng-fei1*,DENG Ben-qiang1* |
(1. Stroke Center, Changhai Hospital, Navy Medical University(Second Military Medical University), Shanghai 200433, China;
2. Nursing College, Navy Medical University(Second Military Medical University), Shanghai 200433, China
*Corresponding authors) |
| Abstract: |
| 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. |
| Key words: acute ischemic stroke time tracking informatization intravenous thrombolysis endovascular treatment |
