影响急性缺血性卒中患者延迟入院的相关因素分析

发布时间：2018-05-29 13:49

本文选题：脑卒中 + 院前延迟　；参考：《重庆医科大学》2013年硕士论文

【摘要】：目的了解影响急性缺血性脑卒中患者延迟入院的相关因素，寻求能帮助减少院前延迟的方法。方法于2012年4月至2012年10月连续对243例于重庆医科大学附属第二医院神经内科住院的急性缺血性卒中患者进行调查。通过筛选，共有217例患者符合我们的标准，被纳入研究。医务人员采用自制的调查问卷，记录患者的一般信息、起病情况、发病后的反应及就诊过程等因素。结果所研究的217例患者平均年龄为（67.1±11.8）岁，所有患者从症状发生至寻求医学帮助的中位数时间为10（3-30.5）h，从症状发生至到达医院的中位数时间为12（3.5-48）h。单因素分析显示：症状发生突然、起病后症状有波动、对卒中症状识别个数越多、最先发现症状的是他人、自己及他人意识到出现中风、自觉症状严重及不能控制症状、认为需要紧急治疗、寻求帮助时没有犹豫、心情焦虑、发病后的反应为寻求医学帮助、首诊医生为120急救医生等因素能帮助减少院前延迟（P＜0.05），而较重的症状（NHISS评分＞10分）能减少从症状发生至达到医院的时间（P＜0.05）。多因素回归分析显示：患者发病后的即刻反应为寻求医学帮助、首诊医生为120急救医生、他人意识到发生中风及他人建议寻求医学帮助与院前延迟的缩短有关。结论通过以上研究，，我们得出结论：使公众意识到卒中发生后积极寻求医学帮助的益处，提高急救系统的使用率，广泛的对卒中高危人群的家属及护理人员进行安全教育，对急缺血性卒中患者的早期诊断与治疗具有重要的意义。
[Abstract]:Objective to investigate the factors related to delayed admission to hospital in patients with acute ischemic stroke and to find ways to help reduce the delay in pre-hospital. Methods from April 2012 to October 2012, 243 patients with acute ischemic stroke in the Department of Neurology, second affiliated Hospital of Chongqing Medical University were investigated. A total of 217 patients met our criteria and were included in the study. A self-made questionnaire was used to record the general information of the patient, the onset of the disease, the reaction after the onset of the disease and the process of seeing a doctor. Results the mean age of 217 patients was 67.1 卤11.8 years old. The median time from symptom onset to seeking medical help was 100.3-30.5h. the median time from symptom onset to hospital arrival was 123.5-48h. Univariate analysis showed that symptoms suddenly occurred and symptoms fluctuated after onset. The more the number of recognized stroke symptoms, the first to find the symptoms was others. Oneself and others were aware of the occurrence of stroke, conscious symptoms were serious and could not be controlled. Thinking that urgent treatment is needed, that there is no hesitation in seeking help, that the mood is anxious, and that the response after the onset of the disease is to seek medical help. The factors such as 120 first-aid doctors for the first visit can help to reduce the pre-hospital delay (P < 0.05), and the severe symptom (NHISS > 10) can reduce the time from the onset of symptoms to reaching the hospital (P < 0.05). Multivariate regression analysis showed that the immediate response of the patient was to seek medical help, and the first doctor was 120 emergency doctors. Others realized that stroke and other people's advice to seek medical help were related to the shortening of the pre-hospital delay. Conclusion based on the above studies, we conclude that the public should be aware of the benefits of seeking medical help after stroke, improve the utilization rate of emergency system, and widely educate the family members and nursing staff of high risk groups of stroke. It is of great significance for the early diagnosis and treatment of acute ischemic stroke.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R743.3

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