Pai-Yu Huang, Yi-Ching Tsai, Chih-Lin Chen, Mei-Chuan Wu, Chiao-Chin Ku, Ping-Chih Shih

Objective: Acute ischemic stroke (AIS) is the leading cause of death and disability in Taiwan. Intervention of endovascular thrombectomy (EVT) as early as possible can effectively improve the prognosis of patients. From January 2020 to April 2021, the emergency room of our hospital performed EVT Door-to-Puncture time, with an average time of 181.3 minutes, mRS<2 points 14.3%, mTICI (level 2b & 3) 78.6%, and average hospitalization days of 36.8 days. Therefore, the purpose of this study is to shorten the EVT Door-to-Puncture time.

Methods: According to the steps of the quality control circle, find out the real cause, formulate countermeasures, revise the operation guidelines of the stroke center, introduce AI Deep CT auxiliary system, hold EVT-related education and training, and formulate EVT standardization.

Results: Statistics of EVT Door-to-Puncture time from September 1, 2021 to December 31, 2021, with an average time of 112 minutes, mTICI (level 2b & 3) 100%, mRS<2 points 60%, and hospitalization days 32.3 sky.

Conclusion and discussion: The results of this study show that shortening the EVT Door-to-Puncture time is helpful to the patient’s prognosis. Therefore, it is recommended to set up an executive team and have a fast track to shorten the IAT Door-to-Puncture time.

黃沛榆，蔡宜靜，陳致霖，吳美娟，古巧琴，施秉志

目的：急性缺血性腦中風 (acute ischemic stroke, AIS) 是臺灣死亡和殘疾的主因。盡早介入顱內動脈取栓術（endovascular thrombectomy, EVT），有效提升病人預後。本院 2020 年 1 月 -2021 年 4 月急診室執行 EVT Door-to-Puncture 時間，平均時間 181.3 分，mRS<2 分 14.3%，mTICI （2b & 3 級） 78.6%，平均住院日 36.8 天，因此本研究目的縮短 EVT Door-to-Puncture 時間。

方法：依品管圈步驟進行找出真因擬定對策修訂腦中風中心作業指引、導入 AI Deep CT 輔助系統、舉辦 EVT 相關教育訓練、制定 EVT 標準化。

結果：統計 2021 年 9 月 1 日 -2021 年 12 月 31 日執行 EVT Door-to-Puncture 時間，平均時間 112 分，mTICI （2b & 3 級） 100%，mRS<2 分 60%，住院天數 32.3 天。

結論與討論：本研究結果顯示縮短 EVT Door-to-Puncture 時間，有助於病人預後，因此建議須成立執行團隊且有快速通道，更能縮短 IAT Door-to-Puncture 時間。