Effect of optimized green channel under plan-do-check-action on shortening door-to-needle time and improving early neurological function in patients with intravenous thrombolysis
10.3760/cma.j.cn115455-20200418-00492
- VernacularTitle:计划-执行-检查-行动循环法优化卒中绿色通道对缩短到院至溶栓时间和改善早期神经功能的影响
- Author:
Lan MA
1
;
Qingwei MENG
;
Kai DUAN
;
Qian CHEN
;
Huaiyu HAO
Author Information
1. 首都医科大学良乡教学医院神经内科 102401
- From:
Chinese Journal of Postgraduates of Medicine
2020;43(11):990-994
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of optimized construction of green channel under plan-do-check-action (PDCA) on shortening the door-to-needle time (DNT) and improving early neurological improvement in patients with acute ischemic stroke (AIS) treated with intravenous thrombolysis.Methods:The clinical data of 120 patients with AIS treated with intravenous thrombolysis from June 2018 to September 2019 in Liangxiang Teaching Hospital of Capital Medical University were retrospectively analyzed. Among them, 60 patients were admitted to hospital before optimized as non-optimized group, and 60 patients were admitted to hospital after optimized as optimized group. The time from visit to CT examination completion, time from CT examination completion to informed consent, time from informed consent to intravenous thrombolysis, DNT, DNT ≤ 60 min ratio, National Institutes of Health stroke scale (NIHSS) score 2 h after intravenous thrombolysis and at discharge from hospital, early neurological improvement (ENI) rate, hospital stays, adverse outcomes and mortality were compared between 2 groups.Results:The time from CT examination completion to informed consent and DNT in optimized group were significantly shorter than those in non-optimized group: 29 (14, 36) min vs. 37 (21, 54) min, 55 (45, 67) min vs. 76 (54, 93) min, the DNT ≤ 60 min ratio was significantly higher than that in non-optimized group: 68.3% (41/60) vs. 35.0% (21/60), the ENI rate was significantly lower than that in non-optimized group: 28.3% (17/60) vs. 46.7% (28/60), and there were statistical differences ( P<0.05 or<0.01). There were no statistical differences in the time from visit to CT examination completion, time from informed consent to intravenous thrombolysis, NIHSS score 2 h after intravenous thrombolysis, hospital stays, NIHSS score at discharge from hospital, adverse outcomes rate and mortality between 2 groups ( P>0.05). Conclusions:The optimized construction of green channel under PDCA can effectively shorten the DNT of intravenous thrombolysis in patients with AIS, and may be significantly important for improving the long-term prognosis of patients.
