急性脑卒中就诊时间及其影响因素分析

目的探讨急性脑卒中就诊时间及其影响因素。方法收集2010年9月～2011年4月在天津医科大学总医院神经内科急诊室就诊的脑卒中患者748例,记录就诊时间和到达急诊室的方式,分析脑卒中类型、病情轻重、发病次数、职业、文化程度及首发症状对就诊时间是否有影响。结果 748例患者中,仅22.99%的患者在发病<2 h到达医院就诊,31.95%的患者在发病2～6 h到医院就诊,到达急诊室最常见的转运方式是出租车(37.97%)。脑出血、病情重、高中及以上文化程度、干部及专业技术人员就诊时间≤6 h比例高(P<0.05),首发症状以头痛、意识障碍、癫痫发作以及≥3个症状的患者就诊时间短(P<0.05)。结论公众对脑卒中的识别能力低、急救意识差,院前急救系统不完善,缺乏救护人员对脑卒中救治的规范化培训,院前延误治疗十分严重。

Visiting time of acute cerebral stroke patients and its influence factors

Objective To study the visiting time of acute cerebral stroke patients and its influence factors.Methods Seven hundred and forty-eight cerebral stroke patients who visited Emergency Department,General Hospital of Tianjin Medical University from September 2010 to April 2011 were included in this study.Their visiting time and ways of arriving at the Emergency Department were recorded.Effect of types and severity of cerebral stroke,number of its occurrences,and occupation, education level and initial symptoms of the patients on their visiting time was analyzed.Remits The visiting time was <2 h and 2—6 h,respectively,in 22.99%and 31.95%of the patients after the onset of their disease.The patients uasually went to hospital by taxi,accounting for 37.97%.The patients were diagnosed as hemorrhagic cerebral stroke with severe symptoms. The proportion of patients graduated from senior middle school,cadres and technicians with a visiting time≤6 h was higher and the visiting time of those with their initial symptoms≥3 such as headach,disturbance of consciousness and epilesy was shorter(P<0.05).Conclusion The public have a poor ability to recognize cerebral stroke and seek for first-aid.The prehospital first-aid system is imperect.The medical staff lack of standard training for the first-aid of cerebral stroke and the prehospital first-aid delay is severe.