北京等15个城市脑卒中患者院前时间及影响因素研究

毕齐; 张茁; 张微微; 李琴

Abstract

毕齐,张茁,张微微,李琴.北京等15个城市脑卒中患者院前时间及影响因素研究[J].Chinese journal of Epidemiology,2006,27(11):996-999

北京等15个城市脑卒中患者院前时间及影响因素研究

Study on prehospital time and influencing factors of stroke patients in 15 Chinese cities

Received:January 26, 2006

DOI：

KeyWord: 脑卒中院前时间影响因素溶栓治疗

English Key Word: Stroke Prehospital time Influence factor Thrombolysis

FundProject:

Author Name	Affiliation
BI Qi	Department of Neurology, Anzhen Hospital Affiliated with Capital University of Medical Science, Beijing 100029, China
ZHANG Zhuo	Department of Neurology, Anzhen Hospital Affiliated with Capital University of Medical Science, Beijing 100029, China
ZHANG Wei-wei	北京军区总医院神经内科
LI Qin	Department of Neurology, Anzhen Hospital Affiliated with Capital University of Medical Science, Beijing 100029, China

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Abstract:

目的研究北京等15个城市35家医院脑卒中患者到达医院前时间(院前时间)及其影响因素。方法通过统一的问卷,对2002年6月30日至2003年4月30日发病一周内的2270例脑卒中患者进行调查。除一般资料外,按是否在脑卒中症状发生后6 h内到达医院将患者分为两组,对影响脑卒中院前时间的因素进行单因素和多因素logistic回归分析。结果(1)患者的平均年龄为64．8岁,男性占60．2%。缺血性脑卒中为78．8%,出血性脑卒中为21．2%。(2)发病后决定马上去医院的占27．8%。使用急救电话和急救车的比例为27．2%；约1/4患者知道脑卒中后需要马上去医院诊治和溶栓治疗；1/4的患者对脑卒中基本无认识,发病后不知道求救而盲目等待。(3)发病后≤6 h到达医院的患者占57．5%；首次就诊地点是急诊室的为58．6%；发病后≤6 h到达医院的缺血性脑卒中溶栓率为6．7%。(4)影响脑卒中患者院前时间的多因素分析显示：到达医院的方式、首次就诊的地点、发病地点到医院的距离、是否了解疾病的相关知识是影响患者≤6 h到达医院的独立因素。结论42．5%脑卒中患者不能在发病后6 h内到达医院,其院前时间延误的主要原因是对脑卒中知识了解不够、使用急救电话/急救车少、患者转运距离超过20 km等。加强公众对脑卒中知识的了解是提高患者6 h内到达医院的重要因素。

English Abstract:

Objective To study the prehospital time and influence factors of stroke patients in 35 hospitals from 15 cities.Methods Unified questionnaires were used to investigate all of the 2270 stroke patients after at the first week of onset from June 30,2002 to April 30,2003.Other than general data,the patients were divided into two groups according to prehospital time within or after 6 hours and all the factors influencing prehospital time of stroke patients were analysed with Chi-Square test and logistic regression. Results (1)All patients aged 18-102 with mean 64.8 y±11.9 y including 60.2% of males. 78.8% of the patients were diagnosed as ischemic stroke and 21.2 % hemorrhagic stroke.(2)27.8 % of the patients arriving at hospital immediately after the onset of stroke and 27.2 % made emergency calls for ambulance. Only 25% of the patients had the sense that they should go to the hospital and receiving thrombolysis therapy after the onset of symptoms.25 % of the patients were ignorant of any knowledge about stroke,did not ask for help but waiting.(3)57.5% of the patients arriving in hospital≤6 hours after the onset and 58.6% went to emergency room directly.Thrombylysis rate among ischemic stroke patients arrived in hospitals≤6 hours was 6.7%.Multivariate logistic regression analysis showed following factors were related to arriving in hospital within 6 hours with P＜0.001:whether to emergency room directly,to hospital by ambulance or not,distance between stroke onset site to hospital,whether patients know thrombolysis was immediately needed after the onset of stroke,whether more attention to he paid on stroke after the onset of symptoms,whether needs to go to hospital at once after the onset ect.Conclusion The main reasons for 42.5 % stroke patients who arrived hospital over 6 hours were:lack of stroke knowledge, less using emergency call/ambulance,over 20 km between the site where stroke onset was occured and the hospital etc.To enhance public awareness about stroke was important to shorten the patients' arriving hospital' s time.

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