武汉市部分地区急性脑卒中患者院前延迟因素分析

发布时间：2018-04-24 12:51

本文选题：脑卒中 + 溶栓治疗　；参考：《华中科技大学》2013年硕士论文

【摘要】：目的：调查武汉市部分三级医院急性脑卒中患者的院前延迟时间分布情况，并分析其影响因素。方法：对2011年7月至2012年3月武汉市11家三级医院663例急性脑卒中患者及家属进行问卷调查。调查的内容包括患者的社会人口学资料、临床特征、卒中症状认知情况、起病后的就医行为、院前时间。按症状出现4小时内是否入院将其分为延迟组和非延迟组，采用单因素和多因素Logistic回归分析法分析上述因素与院前延迟的相关性。结果：共调查了663例急性脑卒中患者，所有患者均经神经专科检查和影像学检查如头部CT或MRI检查后临床诊断为急性脑卒中。(1)患者年龄中位数为63.1(12-99)岁；(2)男性有451人，占68.0%；(3)急性脑梗死患者有450例，占67.9%；(4)居住在城区者有384例，占57.9%；(5)在家中发病者有566例，占85.4%；(6)既往有脑卒中史的患者有151例，占22.8%；(7)出现症状后有291名患者立即就医，占43.9%；(8)有194名患者是用救护车转运入院，占29.3%；(9)发病后4h内入院的患者有315名，，占47.5%；(10)多因素Logistic回归分析显示：居住地点、有无脑卒中史、入院的转运方式和卒中症状认知度是影响患者是否能在4小时内到达医院的独立因素。结论： 1.卒中知识缺乏；2.周边医疗条件差；3.不会使用120急救系统；4.缺乏交通工具；5.社会卒中急救系统不够完善等可能为院前延误因素，需要患者、家属、医务工作者及社会共同努力，缩短院前延迟时间。
[Abstract]:Objective: To investigate the distribution of pre-hospital delay time in acute stroke patients in some tertiary hospitals in Wuhan and analyze its influencing factors. Methods: From July 2011 to March 2012, a questionnaire survey was conducted on 663 acute stroke patients and their families in 11 tertiary hospitals in Wuhan. The contents of the investigation included the social demographic data, clinical characteristics, cognitive status of stroke symptoms, medical behavior after onset, and pre-hospital time. The patients were divided into delayed group and non-delayed group according to whether they were admitted to hospital within 4 hours after the onset of symptoms. Univariate and multivariate Logistic regression analysis was used to analyze the correlation between the above factors and pre-hospital delay. Results: A total of 663 patients with acute stroke were investigated. The median age of all patients with acute stroke was 63.1 years (12-99) years old) and 451 men were clinically diagnosed as acute cerebral apoplexy after neuroimaging and CT or MRI examinations. There were 450 patients with acute cerebral infarction and 67.9 patients with acute cerebral infarction. There were 384 patients living in urban areas and 57.9patients living in urban areas. There were 566 patients at home, accounting for 85.4patients. There were 151 patients with a history of stroke, accounting for 22.87patients. (43.9%) 194 patients were transported to hospital by ambulance, 315patients were admitted to hospital within 4 hours after the onset of the disease, accounting for 47.5%) multivariate Logistic regression analysis showed that: place of residence, history of stroke, The mode of transport and the degree of recognition of stroke symptoms are independent factors affecting the patient's ability to reach the hospital within 4 hours. Conclusion: 1. Stroke knowledge is deficient. The peripheral medical conditions are poor. No 120 emergency systems will be used. Lack of transportation. The lack of perfect emergency system of social apoplexy may be the factor of delay before hospital, which needs the joint efforts of patients, family members, medical workers and society to shorten the delay time before hospital.
【学位授予单位】：华中科技大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R743.3

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