摘要
目的探讨急性缺血性卒中(AIS)患者院前延迟的影响因素。方法前瞻性连续选取自2017年4月1日至2018年1月31日于北部战区总医院神经内科住院且发病1周的AIS患者为研究对象。采用统一调查表对患者的一般人口学信息(性别、年龄、是否独居、婚姻情况、文化程度、保险情况)、发病情况(发病时周围是否有人、发病环境、最先判断可能发生脑卒中者、出现症状后的第一决定、有无意识障碍)、院前急救信息(到院方式、首诊医院、发病地点至就诊医院距离)、对脑卒中知识了解情况进行调查。结果共纳入AIS患者498例,其中,162例(32.5%)患者发病至到院时间≤6 h,336例(67.5%)患者发病至到院时间>6 h。多因素Logistic回归分析显示,发病时周围无人、未使用急救车转运、发病地点至就诊医院距离远、发病时无意识障碍是AIS患者院前延迟的影响因素(P<0.05)。结论AIS患者发病后存在明显院前延迟,需加强卒中健康教育,增强使用急救车的意识,继续推行卒中急救地图工作,以便将疑似卒中患者在最短时间内转运至最近的经认证的卒中中心。
Objective To investigate the influencing factors of prehospital delay in patients with acute ischemic stroke(AIS).Methods A retrospective study was performed on AIS patients who were admitted and suffered from the disease for 1 week from April 1st 2017 to January 31st 2018.Investigate the information with uniform tables,which included the general demographic data(gender,age,living alone or not,marital status,education,insurance status),onset conditions(is there anyone around,the environment of the onset,the person first judged the possibility of a stroke,the first decision after symptoms,the condition of consciousness),prehospital emergency information(the way to hospital,the first hospital,the distance from the onset location to the hospital),and the knowledge of stroke.Results A total of 498 patients were enrolled,including 162 patients(32.5%)from the onset to the admission time less than 6 hours and 336 patients(67.5%)from the onset to the admission time more than 6 hours.Multivariate Logistic regression analysis showed that no one was around at the time of the onset,no ambulance was used for transportation,the long distance from the onset to hospital,and no unconsciousness was detected were the influencing factors of prehospital delay in AIS patients(P<0.05).Conclusion There is a significant prehospital delay after the onset of AIS.Therefore,stroke health education needs to be strengthened,in addition,awareness of the use of ambulances,and emergency stroke mapping efforts should be continue,in order to transfer suspected stroke patients to the nearest certified stroke center in the shortest time.
作者
万婷
潘俊超
蒋智林
WAN Ting;PAN Jun-chao;JIANG Zhi-lin(Department of Neurology,General Hospital of Northern Theater Command,Shenyang 110016,China)
出处
《创伤与急危重病医学》
2020年第2期69-71,共3页
Trauma and Critical Care Medicine
基金
辽宁省自然科学基金资助项目(20170540913)。
关键词
急性缺血性卒中
院前延迟
影响因素
Acute ischemic stroke
Prehospital delay
Influencing factors
