快速急诊内科评分及时间窗在脑梗死患者急诊中的应用价值

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摘要目的探讨急性缺血性脑卒中患者采用快速急诊内科评分（REMS）及时间窗对其病情判断及有效救治的参考价值。方法回顾性分析2015年1月～2018年12月解放军联勤保障部队908 医院急诊科就诊的90例急性脑梗死患者的临床资料。根据患者生存状况分成生存组（77例）和死亡组（13例）。采用REMS 对生存组、死亡组的患者的年龄、脉搏、血压、呼吸、格拉斯哥昏迷评分（GCS）、经皮脉搏氧饱和度（SpO2）赋值评分。比较两组患者6 项指标REMS评分，同时比较两组患者时间窗的差异。结果死亡组患者的脉搏、收缩压、呼吸频率、GCS、年龄、SpO2 REMS评分高于生存组，差异有显著统计学意义（P＜0.01）；死亡组平均每项得分值高于生存组。死亡组时间窗长于生存组，死亡组各项GCS评分低于生存组，差异有显著统计学意义（P＜0.01）。结论 REMS 对生存、死亡的急性脑梗死患者的年龄、脉搏、血压、呼吸、GCS、SPO2 评分以及患者救治的时间窗对提高急性脑梗死患者的病情判断与有效治疗有一定的参考价值。

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	龚跃华
	饶桂芬
	徐敏

关键词 ：急性脑梗死, 快速急诊内科评分, 时间窗, 疾病转归预测

Abstract：Objective To explore the reference value of the rapid emergency medical score (REMS) and time windown for their condition judgment and effective treatment in patients with acute ischemic stroke.Methods The clinical data of 90 patients with acute cerebral infarction admitted to No.908 Hospital of the PLA Joint Logistics Support Force from January 2015 to December 2018 were analyzed retrospectively.The patients were divided into survival group (n=77) and death group (n=13) according to their living conditions.REMS was used to evaluate the survival group and the death group,including age,pulse,blood pressure,respiration,Glasgow coma scale (GCS) and percutaneous pulse oxygen saturation (SpO2).The REMS scores of 6 indexes between the two groups were compared.At the same time,the difference in time window was compared between the two groups.Results Pulse,systolic blood pressure,respiratory frequency,GCS,age and SpO2 REMS scores of patients in the death group were higher than those in the survival group,and the differences were statistically significant (P＜0.01).The average score of each item in death group was higher than that in survival group,the time window of the death group was longer than that in survival group,GCS scores of the death group were lower than those in the survival group,and the differences were statistically significant (P＜0.01).Conclusion The age,pulse,blood pressure,respiration,GSC,percutaneous pulse oxygen saturation are scored by REMS for patients with acute cerebral infarction of survival and death,which and time window have certain effects for condition judgment and effective treatment of patients with acute cerebral infarction.

Key words： Acute cerebral infarction Modified rapid emergency medical score Time Window Disease outcome prediction

基金资助:江西省卫生健康委科技计划项目（20204802）

作者简介: 龚跃华（1984-），男，江西南昌人，本科，主治医师，研究方向：严重创伤、心肺脑复苏、急危重症的抢救

引用本文:

龚跃华；饶桂芬；徐敏. 快速急诊内科评分及时间窗在脑梗死患者急诊中的应用价值[J]. 中国当代医药, 2021, 28(5): 42-45.
GONG Yue-hua；RAO Gui-fen；XU Min. Application value of rapid emergency medical score and time window in emergency treatment of patients with cerebral infarction. 中国当代医药, 2021, 28(5): 42-45.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2021/V28/I5/42

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