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Volume 13 Issue 5
Sep.  2022
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Article Navigation >  Medical Journal of Peking Union Medical College Hospital  > 2022  >  13(5): 888-894
ZHOU Lixin, CI Yang, HU Yaxiong, ZHUO Ma, CIDAN Zhuoga, WANG Dongliang, CAO Xudong, WU Kexue, ZHAO Yuhua, PENG Bin. Preliminary Study on the Optimization Effect of Intravenous Thrombolysis in Acute Ischemic Stroke in Lhasa[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(5): 888-894. doi: 10.12290/xhyxzz.2022-0041
Citation: ZHOU Lixin, CI Yang, HU Yaxiong, ZHUO Ma, CIDAN Zhuoga, WANG Dongliang, CAO Xudong, WU Kexue, ZHAO Yuhua, PENG Bin. Preliminary Study on the Optimization Effect of Intravenous Thrombolysis in Acute Ischemic Stroke in Lhasa[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(5): 888-894. doi: 10.12290/xhyxzz.2022-0041
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Preliminary Study on the Optimization Effect of Intravenous Thrombolysis in Acute Ischemic Stroke in Lhasa

doi: 10.12290/xhyxzz.2022-0041
  • 1.

    Department of Neurology, Tibet Autonomous Region People's Hospital, Lhasa 850000, China

  • 2.

    Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

  • 3.

    State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

  • 4.

    Department of Neurosurgery, Peking University People's Hospital, Beijing 100044, China

  • 5.

    Department of Neurosurgery, Tibet Autonomous Region People's Hospital, Lhasa 850000, China

Funds:

Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences 2021-RW320-003

National Natural Science Foundation of Tibet Autonomous Region XZ202001ZY0009G

More Information
  • Corresponding author: ZHAO Yuhua, E-mail: drolyang@163.com
  • Received Date: 2022-01-27
  • Accepted Date: 2022-04-01
    • Available Online: 2022-06-09
  • Publish Date: 2022-09-30
    Abstract
  •   Objective  To explore the improvement effect of green channel process optimization in acute ischemic stroke (AIS) on intravenous thrombolysis (IVT) quality in Lhasa.  Methods  All patients with AIS who received IVT by the stroke center of Tibet Autonomous Region from August 2019 to December 2021 were included. According to whether the stroke green channel process was optimized, they were divided into the pre-optimization group (August 2019 to June 2021) and the post-optimization group (July to December 2021). The quality of IVT and stroke prognosis were compared and analyzed between the two groups.  Results  A total of 34 patients with AIS who received IVT were included (an average of 1.2 patients per month), including 16 in the pre-optimization group and 18 in the post-optimization group. The National Institutes of Health Stroke Scale scores at baseline, immediately after thrombolysis, and 24 hours after thrombolysis were 6.5(3.0, 12.0), 3.0(1.0, 5.5)and 2.0(0, 6.3), respectively. The door to needle time in the post-optimization group was significantly shortened, as compared with that of the pre-optimization group[(67.1±37.8)min vs. (108.9±53.8)min, P=0.035]. Onset to needle time [(176.7±69.7)min vs. (199.1±47.8)min, P=0.065], the compliance rate of door to needle time ≤60 min (50.0% vs. 18.8%, P=0.061) and the proportion of good short-term efficacy of thrombolysis (77.8% vs. 62.5%, P=0.336) were improved, but the differences were not statistically significant.  Conclusions  After the process optimization of stroke green channel, the in-hospital delay of IVT for AIS in Lhasa is significantly improved, which is helpful to enhance the first-aid efficiency of early treatment of AIS.
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  • [1] 王拥军, 李子孝, 谷鸿秋, 等. 中国卒中报告2019(中文版)(1)[J]. 中国卒中杂志, 2020, 15: 1037-1043. doi:  10.3969/j.issn.1673-5765.2020.10.001
    [2] 中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南2018[J]. 中华神经科杂志, 2018, 51: 666-682. doi:  10.3760/cma.j.issn.1006-7876.2018.09.004
    [3] Powers WJ, Rabinstein AA, Ackerson T, et al. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association[J]. Stroke, 2019, 50: e344-e418. doi:  10.1161/STROKEAHA.118.022606
    [4] 王陇德, 王金环, 彭斌, 等. 《中国脑卒中防治报告2016》概要[J]. 中国脑血管病杂志, 2017, 14: 217-224. doi:  10.3969/j.issn.1672-5921.2017.04.010
    [5] 张涛, 赵玉华, 郝渝, 等. 拉萨地区脑卒中464例分析[J]. 中华神经科杂志, 2015, 48: 861-865. doi:  10.3760/cma.j.issn.1006-7876.2015.10.009
    [6] 中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国急性脑梗死后出血转化诊治共识2019[J]. 中华神经科杂志, 2019, 52: 252-265.
    [7] Wilson MH, Newman S, Imray CH. The cerebral effects of ascent to high altitudes[J]. Lancet Neurol, 2009, 8: 175-191. doi:  10.1016/S1474-4422(09)70014-6
    [8] 次旦卓嘎, 司洋, 张勤, 等. 拉萨地区住院脑卒中患者的类型及其危险因素分析[J]. 中华神经科杂志, 2010, 43: 196-198. doi:  10.3760/cma.j.issn.1006-7876.2010.03.008
    [9] Li J, Liu J, Ma Y, et al. Imbalanced Regional Development of Acute Ischemic Stroke Care in Emergency Departments in China[J]. Emerg Med Int, 2019, 2019: 3747910.
    [10] 《中国卒中中心报告2019》编写组. 《中国卒中中心报告2019》概要[J]. 中国脑血管病杂志, 2021, 18: 355-360. doi:  10.3969/j.issn.1672-5921.2021.05.013
    [11] Speirs L, Mitchell A. Meet Me in Computed Tomography Suite: Decreasing Tissue Plasminogen Activator Door-to-Needle Time for Acute Ischemic Stroke Patients[J]. J Emerg Nurs, 2015, 41: 381-386. doi:  10.1016/j.jen.2015.01.005
    [12] Cha JK, Nah HW, Kang MJ, et al. Outcomes after tissue plasminogen activator administration under the drip and ship paradigm may differ according to the regional stroke care system[J]. J Stroke Cerebrovasc Dis, 2014, 23: 160-163. doi:  10.1016/j.jstrokecerebrovasdis.2013.07.032
    [13] Xian Y, Smith EE, Zhao X, et al. Strategies used by hospitals to improve speed of tissue-type plasminogen activator treatment in acute ischemic stroke[J]. Stroke, 2014, 45: 1387-1395. doi:  10.1161/STROKEAHA.113.003898
    [14] 邢鹏飞, 张永巍, 陈蕾, 等. 医院诊治模式的改变对急性缺血性卒中患者救治时间的影响[J]. 中国脑血管病杂志, 2015, 12: 617-620. doi:  10.3969/j.issn.1672-5921.2015.12.001
    [15] Chao BH, Yan F, Hua Y, et al. Stroke prevention and control system in China: CSPPC-Stroke Program[J]. Int J Stroke, 2021, 16: 265-272. doi:  10.1177/1747493020913557
    [16] Fonarow GC, Smith EE, Saver JL, et al. Improving door-to-needle times in acute ischemic stroke: the design and rationale for the American Heart Association/American Stroke Association's Target: Stroke initiative[J]. Stroke, 2011, 42: 2983-2989. doi:  10.1161/STROKEAHA.111.621342
    [17] Wang Y, Li Z, Zhao X, et al. Effect of a Multifaceted Quality Improvement Intervention on Hospital Personnel Adherence to Performance Measures in Patients With Acute Ischemic Stroke in China: A Randomized Clinical Trial[J]. JAMA, 2018, 320: 245-254. doi:  10.1001/jama.2018.8802
    [18] Meretoja A, Strbian D, Mustanoja S, et al. Reducing in-hospital delay to 20 minutes in stroke thrombolysis[J]. Neurology, 2012, 79: 306-313. doi:  10.1212/WNL.0b013e31825d6011
    [19] Meretoja A, Weir L, Ugalde M, et al. Helsinki model cut stroke thrombolysis delays to 25 minutes in Melbourne in only 4 months[J]. Neurology, 2013, 81: 1071-1076. doi:  10.1212/WNL.0b013e3182a4a4d2
    [20] Schwamm LH, Fonarow GC, Reeves MJ, et al. Get With the Guidelines-Stroke is associated with sustained improvement in care for patients hospitalized with acute stroke or transient ischemic attack[J]. Circulation, 2009, 119: 107-115. doi:  10.1161/CIRCULATIONAHA.108.783688
    [21] 楼敏, 王伊龙, 李子孝, 等. 中国卒中中心建设指南[J]. 中国卒中杂志, 2015, 10: 499-507. https://www.cnki.com.cn/Article/CJFDTOTAL-ZUZH201506013.htm
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