目的：总结急诊溶栓病例溶栓效果、安全性以及各关键时间节点，以期优化急诊溶栓流程，改善患者预后。

方法：回顾性分析2019年1月—10月接受急诊溶栓治疗的20例超早期急性脑梗死患者的临床资料，总结治疗结果，计算溶栓过程中的各个关键时间节点，与国内专家共识推荐的时间节点进行对比，分析延迟原因，为急诊溶栓流程优化提出思考和建议。

结果：20例超早期急性脑梗死患者接受急诊静脉溶栓治疗，其中男性9例、女性11例，中位年龄为74.5岁，急诊接诊至血样本抽取的中位时间为11.0 min，接到血液标本至出具化验报告的中位时间为25.5 min，到院至开始头颅CT扫描的中位时间为19.5 min，到院至CT阅片出报告的中位时间为39.5 min，完成签署知情同意书和给药的中位时间为27.5 min，到院至溶栓治疗开始的中位时间为63.5 min，痊愈率为30.0%，总的显效率为90.0%，不良事件发生率为45.0%（主要为轻微的口腔和牙龈出血）。

结论：超早期急性脑梗死患者接受急诊静脉溶栓治疗的总体有效率和安全性均较高，但存在院内延迟问题，需采取相应措施，如加强对公众进行脑梗死宣教、提高知情同意谈话技巧以及在急诊抢救室内预先储备溶栓药物等，以进一步缩短从到院至静脉溶栓的时间。

Objective: To summarize the efficacy and safety of intravenous thrombolysis and the key time lines with an aim to optimize the process of emergent thrombolysis and improve the prognosis of patients.

Methods: The clinical records of 20 cases of hyper-early acute cerebral infarction treated with intravenous thrombolysis from January 2019 to October 2019 were retrospectively analyzed. The outcomes were summarized and the key time lines were calculated and compared with the time lines that are recommended by the expert consensus. After that, the reasons for in-hospital delay were analyzed and came up with suggestions to optimize the process of emergent thrombolysis.

Results: A total of 20 cases of hyper-early acute cerebral infarction treated with intravenous thrombolysis were enrolled, including 9 men and 11 women. The median age was 74.5 years old. The median time from entering the hospital to cranial CT scanning was 19.5 minutes. The median time from receiving blood sample to test report were 25.0 minutes. The median time from entering the hospital to cranial CT result was 39.5 minutes. The median time of informed consent and administration of thrombolytic drug was 27.5 minutes. The median door to needle time (DNT) was 63.5minutes. The cure rate was 30.0%, while the general effective rate was 90.0%. Moreover, the incidence of adverse events was 45.0% which mainly included mild bleeding of mouth and gums.

Conclusion: The efficacy and safety of intravenous thrombolysis on hyper-early acute cerebral infarction were generally good, but there was problem of in-hospital delay. Some measures such as strengthening public education on cerebral infarction, improving the technique of informed consent and pre-reserving thrombolytic drug in the emergency room should be taken, so as to further shorten the DNT.