医联体救治模式对急性缺血性脑卒中患者救治效率及预后的影响 [中文引用][英文引用]

目的  观察医联体救治模式下卒中中心区域协同救治体系对急性缺血性脑卒中（acute ischemic stroke，AIS）患者救治效率和预后的影响。方法  采用回顾性队列研究设计，选取 2023 年 5 月至 2024 年 12 月深圳市某三级甲等综合医院收治的 254 例 AIS 患者作为研究对象，将实施医联体救治模式进行救治的 140 例患者作为研究组，实施常规卒中救治流程的 114 例患者作为对照组，比较两组患者入院至静脉溶栓药物给药时间（door-to-needle time，DNT）、入院至血管穿刺成功的时间（doorto-puncture time，DPT）、入院至 CT 时间、干预前后美国国立卫生研究院卒中量表（National Institute of Health stroke scale，NIHSS）评分和改良 Rankin 量表（modified Rankin scale，mRS）评分。结果  两组患者 DNT 时间比较，差异无统计学意义（P>0.05）；研究组 DPT 及入院至 CT 时间短于对照组，两组比较，差异具有统计学意义（P<0.05）。研究组入院时与治疗后 7d 的 NIHSS 评分差值大于对照组（P<0.001）；研究组较对照组治疗后 90d 和 180d 的 mRS 评分组间效应和时间效应显著，差异具有统计学意义（均P<0.05）。结论  医联体救治模式可优化 AIS 患者救治流程，缩短再灌注时间，有助于改善 AIS 患者神经功能预后。

Objective To observe the impact of medical alliance model on therapeutic efficiency and prognosis in patients with acute ischemic stroke（AIS）. Methods A retrospective study were conducted on 254 AIS patients who were admitted to our hospital between May 2023 and December 2024. The patients were divided into an research group（n=140，treated under the medical alliance） and a control group（n=114，receiving conventional stroke care）. Key outcomes including door-to-needle time（DNT），door-to-puncture time（DPT），and scores of National Institute of Health stroke scale（NIHSS）and modified Rankin scale，mRS）were compared between the two groups. Results There was no statistically significant difference in DNT time between the two groups of patients（P>0.05）. The DPT and door-to-CT time in the research group were significantly shorter than those in the control group（P<0.05）. The NIHSS score differance at 7 days and post-treatment was significantly higher than that in the control group（P<0.001）. Compared with the control group，the research group showed significant inter group and time effects in mRS scores at 90 and 180 days after treatment，with statistical significance（both P<0.05）. Conclusion The medical alliance model can optimise the treatment process for AIS patients and shorten reperfusion time，thereby contributing to the improvement of neurological functional outcomes.