探讨在某基层县级医院急诊卒中绿色通道的建设对急性缺血性脑卒中（AIS）患者临床救治情况的影响。

选取2018年11月至2019年11月经郸城县人民医院急诊科收治的179例AIS患者作为对照组，2020年1月至12月实施急诊卒中绿色通道管理策略后在该院急诊科收治的202例AIS患者作为作为研究组。2组患者均符合《中国急性缺血性脑卒中诊治指南2018》中静脉溶栓治疗的适应证并排除禁忌证，2组患者均单独采取静脉溶栓治疗。采取回顾性分析，通过χ2检验比较2组患者同期溶栓率和36 h内出血并发症发生率的差异，采用t检验比较2组患者入院至溶栓治疗时间（DNT）、3个月后的神经功能缺损恢复[美国国立卫生研究院卒中量表评分差（ΔNIHSS）]、生活质量提高情况[改良Rankin量表评分差（ΔmRs）]的差异。

研究组AIS患者溶栓率为14.17%，较对照组（8.96%）升高，差异具有统计学意义（χ2=19.747，P＜0.001），2组患者36 h内出血并发症发生率比较，差异无统计学意义（P＞0.05）；研究组患者DNT为（33.14±3.37）min，较对照组[（74.36±7.97）min]减少，差异具有统计学意义（t=26.872，P＜0.001）；分析3个月后研究组的康复情况，ΔNIHSS、ΔmRs优于对照组[（11.12±2.95）分 vs（6.83±3.30）分；（3.21±0.21）分 vs（1.64±0.43）分]，差异均具有统计学意义（t=21.181、23.458，P均＜0.001）。

县级医院通过创建卒中中心，实施急诊卒中绿色通道管理后，AIS患者的DNT明显缩短，提高了患者血管再通治疗的效率，有利于患者相关功能的恢复。

To explore the influence of the establishment of emergency stroke green channel on the treatment of acute ischemic stroke (AIS) patients in primary county hospitals.

A total of 179 patients with AIS, who were admitted to the emergency department of Dancheng County People's Hospital from November 2018 to November 2019, were selected as the control group. Another 202 patients with AIS admitted to the identical department after establishment of the green channel stroke management from January 2020 to December 2020 were enrolled as the study group. Both groups met the Chinese guidelines for the diagnosis and treatment of acute ischemic stroke 2018. The patients with contraindications of intravenous thrombolysis therapy were excluded. A retrospective analysis was conducted to compare thrombolysis rate and bleeding rate within 36 hours by χ2 test. Time from admission to thrombolytic therapy (DNT), recovery of neurological function defects 3 months after stroke and improvement of life quality between the two groups were compared by t-test.

The thrombolysis rate of AIS in the study group was 14.17%, higher than that in the control group (8.96%; χ2=19.747, P＜0.001). There was no significant difference of bleeding rate within 36 hours between groups (P＞0.05). DNT of the study group was (33.14±3.37)min and control group was (74.36±7.97)min, showing the statistically significant difference (t=26.872, P＜0.001). ΔNIHSS and ΔmRs score (11.12±2.95, 3.21±0.21) in the study group after 3 months were significantly better than that of the control group (6.83±3.30, 1.64±0.43) (t=21.181, 23.458; all P＜0.001).

After establishing stroke centers in county hospitals, the management of emergency stroke green channel could shorten the DNT in patients with acute ischemic stroke, which improves the efficiency of revascularization therapy and is conducive to the recovery of related functions.