使用tPA 治療缺血性中風的效果會隨著到院至給藥時間(door to needle time, DNT)的延長而減低， 本研究的目的在檢討有哪些原因會造成DNT 大於60 分鐘。分析2012 及2013 年的急性腦梗塞中風病人 資料，將完成急性中風實驗室檢查及電腦斷層所需的時間定義為「完成所有檢驗所需時間」，分析「完成 所有檢驗所需時間」與DNT＞60 分鐘是否相關，並分析DNT 超過60 分鐘的因素。結果：「完成所有檢 驗所需時間」與DNT 是否超過60 分鐘沒有顯著相關；DNT 超過60 分鐘的因素，檢驗時間過長占23.8%， 家屬因素占14.3%，病情因素占42.3%，行政因素占4.8%，無明顯原因占14.3%。結論：除了繼續努力縮 短檢驗時間，我們應在等待檢驗結果的同時請家屬考慮適合時是否施打，儘早量體重、領藥、控制血壓， 並考慮降低或取消臨床疾病嚴重度 National Institutes of Health Stroke Scale 的下限。

Efficacy of intravenous alteplase to treat acute ischemic stroke decreases with door-to-needle time (DNT). This study aimed to determine what led to DNT> 60 minutes. We analyzed the data of acute ischemic stroke patients in 2012 and 2013, and defined "door to all laboratory data" as the time needed to finish brain CT, CBC, and PT/aPTT. Then we tested whether "door to all laboratory data" time was associated with whether DNT was longer than 60 minutes. Lastly we analyzed the factors leading to DNT> 60 minutes. "Door to all laboratory data" time was not significantly related to whether DNT was longer than 60 minutes. Factors leading to DNT> 60 minutes, "laboratory time too long" corresponded to 23.8%, "family factor" 14.3%, "disease factor" 42.3%, "administration factor" 4.8%, and "no obvious cause" 14.3%. In order to further shorten the laboratory time, we should talk to family about whether to use alteplase if feasible, before the laboratory results are available. We should also measure the patients' weight, get alteplase at hand, and control the blood pressure as early as possible. Lastly, we should consider lowering or canceling the lower limit of National Institutes of Health Stroke Scale.