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  • 沈红健,邢鹏飞,张永鑫,吴涛,张永巍,柯骏,刘建民,杨鹏飞,邓本强.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[J].第二军医大学学报,2018,39(9):977-982    [点击复制]
  • SHEN Hong-jian,XING Peng-fei,ZHANG Yong-xin,WU Tao,ZHANG Yong-wei,KE Jun,LIU Jian-min,YANG Peng-fei,DENG Ben-qiang.Effect of informationized time tracking management mode on treatment speed of acute ischemic stroke[J].Acad J Sec Mil Med Univ,2018,39(9):977-982   [点击复制]
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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*
0
(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)
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).
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