对静脉溶栓从门到针时间的影响:可行性研究。

IF 1.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Acta Clinica Belgica Pub Date : 2020-08-01 Epub Date: 2019-05-11 DOI:10.1080/17843286.2019.1607991
Joke Vanhoucke, Dimitri Hemelsoet, Eric Achten, Veerle De Herdt, Marjan Acou, Elke Vereecke, Saïd Hachimi-Idrissi
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引用次数: 5

摘要

简介:中风是一种急性局灶性神经功能缺损的发展与缺血性或出血性起源。缺血性卒中发生后4.5小时内溶栓可改善预后。指南建议在到达医院后60分钟内静脉注射重组组织型纤溶酶原激活剂,这意味着从门到针的时间(DNT)应少于60分钟。在本研究中,根特大学医院急诊科引入了一项卒中方案,其主要目标是缩短DNT。方法学:本研究为前后对照队列研究。实施“编码中风”协议(CSP),并将编码中风前协议期(CSP前期间,从2016年8月15日至2017年3月5日)的结果与编码中风后协议期(CSP后期间,从2017年3月6日至2017年7月16日)的结果进行比较。结果:中位DNT从csp前的57 min显著下降到csp后的33 min (p < 0.001)。与csp前相比,csp后患者从门到分诊时间(DTT)、从分诊到急诊医生时间(TET)、急诊医生到ct时间(ECT)和ct到针管时间(CNT)显著减少。当调整其他可能影响这些时间间隔的变量的结果时,TET, ECT和CNT也显着下降。CSP的实施对20、30、45和60 min内DNT治疗的患者数量有统计学意义(p = 0.008)。结论:采用该卒中方案可显著降低DNT。
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Impact of a code stroke protocol on the door-to-needle time for IV thrombolysis: a feasibility study.

Introduction: Stroke is a development of an acute focal neurological deficit with an ischemic or hemorrhagic origin. Thrombolysis within 4.5 h of ischemic stroke onset improves outcome. Guidelines recommend administration of intravenous recombinant tissue plasminogen activator within 60 min upon arrival at the hospital, meaning the door-to-needle time (DNT) should be less than 60 min. In this study, a stroke protocol was introduced at the emergency department of the Ghent University Hospital with a primary goal to shorten the DNT.

Methodology: This study was an uncontrolled before-after cohort study. A 'Code Stroke' protocol (CSP) was implemented and the results from the pre-code stroke protocol period (Pre-CSP period, from 15 August 2016 until 5 March 2017) were compared with the results from the post-code stroke protocol period (Post-CSP period, from 6 March 2017 until 16 July 2017).

Results: The median DNT decreased significantly from 57 min in the Pre-CSP period to 33 min in the Post-CSP period (p < 0.001). The door-to-triage time (DTT), triage-to-emergency physician time (TET), emergency physician-to-CT time (ECT) and CT-to needle time (CNT) decreased significantly Post-CSP compared to Pre-CSP. When adjusting the results for other variables that might have an influence on these time intervals, the TET, ECT and CNT also decreased significantly. There was a statistically significant effect of the implementation of the CSP on the number of patients treated with a DNT within 20, 30, 45 and 60 min (p = 0.008).

Conclusion: A significant decrease in DNT can be achieved with the implementation of this stroke protocol.

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来源期刊
Acta Clinica Belgica
Acta Clinica Belgica MEDICINE, GENERAL & INTERNAL-
CiteScore
3.50
自引率
0.00%
发文量
44
期刊介绍: Acta Clinica Belgica: International Journal of Clinical and Laboratory Medicine primarily publishes papers on clinical medicine, clinical chemistry, pathology and molecular biology, provided they describe results which contribute to our understanding of clinical problems or describe new methods applicable to clinical investigation. Readership includes physicians, pathologists, pharmacists and physicians working in non-academic and academic hospitals, practicing internal medicine and its subspecialties.
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