CAJ | 학술논문

目的：探讨急诊一体化运转模式在急性期脑梗死进行溶栓治疗的意义。方法：对比实施急诊一体化运转模式前后1年中脑梗死患者进行溶栓治疗的比例和开始溶栓时间；对比发病＜3h、发病＜6h 但＞3h行rt-PA溶栓和发病＞6 h 脑梗死患者行内科保守治疗的三组患者治疗前、治疗后1 d、7 d、21 d 的神经功能情况。结果：实施一体化前后一年中脑梗死患者进行溶栓治疗的比例分别为20．9％和38．3％，开始溶栓时间分别为（4．7±1．5）h 和（3．8±1．6）h；发病＜3 h、发病＞3 h 但＜6 h 进行 rt-PA 溶栓治疗前和发病＞6 h 保守治疗前三组的 NIHSS 评分无明显差异，治疗1d 后 NIHSS 评分分别为（7．2±5．2）分、（8．2±5．5）分和（12．9±4．6）分，7 d 后分别为（4．9±5．9）分、（6．8±6．3）分和（9．7±5．5）分，21 d 后分别为（4．0±4．8）分、（5．7±4．6）分、（8．7±4．0）分，各组间均有明显差异（P ＜0．05）。结论：急救一体化运转模式能有效缩短脑梗死诊断时间，有助于患者得到及时的溶栓治疗，提高脑梗死患者的神经功能恢复程度。
목적：탐토급진일체화운전모식재급성기뇌경사진행용전치료적의의。방법：대비실시급진일체화운전모식전후1년중뇌경사환자진행용전치료적비례화개시용전시간；대비발병＜3h、발병＜6h 단＞3h행rt-PA용전화발병＞6 h 뇌경사환자행내과보수치료적삼조환자치료전、치료후1 d、7 d、21 d 적신경공능정황。결과：실시일체화전후일년중뇌경사환자진행용전치료적비례분별위20．9％화38．3％，개시용전시간분별위（4．7±1．5）h 화（3．8±1．6）h；발병＜3 h、발병＞3 h 단＜6 h 진행 rt-PA 용전치료전화발병＞6 h 보수치료전삼조적 NIHSS 평분무명현차이，치료1d 후 NIHSS 평분분별위（7．2±5．2）분、（8．2±5．5）분화（12．9±4．6）분，7 d 후분별위（4．9±5．9）분、（6．8±6．3）분화（9．7±5．5）분，21 d 후분별위（4．0±4．8）분、（5．7±4．6）분、（8．7±4．0）분，각조간균유명현차이（P ＜0．05）。결론：급구일체화운전모식능유효축단뇌경사진단시간，유조우환자득도급시적용전치료，제고뇌경사환자적신경공능회복정도。
To explore the significance of the integrated emergency operation mode in the acute phaseof cerebral infarction thrombolysis. Method: Compared with the proportion of patients with thrombolytic therapy andthe time start thrombolysis between one year before and after the implement of the integrated emergency operationmode. Contrasted neurological conditions of patients before and after treatment 1 d, 7 d, 21 d of the three groupswhich onset < 3 h, onset < 6 h but > 3 h for rt-PA thrombolysis and morbidity > 6 h infarction patients afterconservative treatment. Results: The thrombolytic therapy in patients with cerebral infarction rates of year before andafter the implementation of integrated were 20.9% and 38.3%, thrombolytic time were (4.7±1.5)h and (3.8±1.6) h.NIHSS score of the three groups before treatment had no significant difference, NIHSS score after treatment 1d were7.2 ±5.2,8.2 ±5.5 and 12.9 ±4.6,NIHSS score after treatment 7 d were 4.9 ±5.9,6.9 ±6.3,9.7 ±5.5,respectively,NIHSS score after treatment 21 d were 4.0 ±4.8,5.7 ±4.6,8.7 ±4.0, difference between the groups was statisticallysignificant (P < 0.05). Conclusion: The integrated emergency operation mode can effectively shorten the integrationtime of diagnosis of cerebral infarction,can improve recovery degree of neurological function in patients with cerebralinfarction because of receiving timely thrombolytic therapy.