1 南京医科大学附属南京医院(南京市第一医院)急诊科，南京 210006
Effect of FOCUS-PDCA mode on platelet and activated partial thrombin time of patients in the reconstruction of emergency treatment process of acute stroke
CorrespondingAuthor: WANG Juan Email: email@example.com
Objective: To explore the effect of find-organize-clarity-understand-select-plan-do-check-act (FOCUS-PDCA) mode on the coagulation function of patients in the reconstruction of emergency treatment process of acute stroke, and to analyze the clinical effect. Methods: Two hundred and five patients with acute ischemic stroke (AIS) who were admitted to Nanjing First Hospital from January 2020 to January 2022 were enrolled in this study, including 105 patients from January 2020 to December 2020 as the control group, and 110 patients from January 2021 to January 2022 as the study group. The control group adopted conventional emergency treatment procedures, and the research group implemented the first-aid procedure based on the FOCUS-PDCA mode transformation. The execution time of the first-aid procedures in the hospital of the 2 groups was mastered, and the neurological function recovery before and 24 h after thrombolytic treatment and at discharge was measured by National Institute of Health Stroke Scale (NIHSS) score. Platelet (PLT) count and activated partial thrombin time (aPTT) were measured before and 24 h after thrombolytic therapy to master the effective rate of emergency thrombolytic therapy, serum fibroblast growth factor 4 (FGF4) and D-dimer (D-D) levels were determined before and after treatment. Results: The hospitalization to CT time, hospitalization to CT report time, and door-to-needle time (DNT) in the study group were significantly shorter than those in the control group (all P<0.05). There was no significant difference in NIHSS score between the 2 groups before thrombolytic therapy (P>0.05), but the NIHSS score at 24 h after thrombolytic therapy and at discharge was significantly lower than that before thrombolytic therapy (both P<0.05), and the NIHSS score in study group was lower than that in control group (both P<0.05). Twenty-four hours after thrombolytic therapy, PLT count and aPTT in the study group were lower than those in the control group (both P<0.05). The total effective rate of emergency thrombolytic therapy was 91.82% in the study group and 80.95% in the control group, the difference was statistically significant (P<0.05). After treatment, serum FGF4 and D-D levels in the study group were lower than those in the control group, the differences were statistically significant (both P<0.05). Conclusion: In acute stroke emergency treatment, the first aid process based on the FOCUS-PDCA mode is helpful to shorten the first aid time, improve the efficiency of first aid thrombolytic therapy, promote the recovery of neurological function and improve the prognosis, which has important clinical significance.