影响脑卒中患者人院延迟的相关因素调查研究

目的探讨目前影响脑卒中患者人院延迟的相关因素。方法对2008年4—9月确诊脑卒中住院患者179例进行问卷调查。根据发病至住院的时间将患者分为≤6h组（85例）和〉6h组（94例），分析影响入院延迟的相关因素。结果179例患者发病至住院的平均时间（26．2±0．1）h，中位时间为7．5h。两组患者既往有心脏病和糖尿病病史、发病地点距医院较近、首发症状有抽搐或意识障碍、首诊地点为急诊室、选择急救120、就诊途中时间等因素比较差异有统计学意义（P〈0．05）。logistic回归分析显示，发病地区远、门急诊处置时间长是影响入院延迟的主要因素。结论目前脑卒中患者入院延迟现象严重，缺血性脑卒中溶栓率低。主要原因在于患者对脑卒中相关知识不了解，不能充分利用院前急救系统。

Investigation and study on the associated factors of hospitalization delay in stroke patients

Objective To study the associated factors of hospitalization delay in stroke patients. Methods Verified questionnaires were used to investigate all of the 179 stroke patients. The patients were divided into two groups according to prehospital time within or after 6 h. The associated factors of hospitalization delay were analyzed. Results The average prehospital time among 179 patients was （26.2 ± 0.1 ） h, the median time was 7.5 h. There were significant differences in previous cardiac disease, distance between stroke onset site to hospital, convulsion or disorders of consciousness onset, first visit in emergency room directly or not, arriving at hospital by ambulance or not, time on ambulance between stroke onset site to hospital, time on route to hospital between the two groups （P 〈 0.05）. Logistic regression showed the following factors were related to hospitalization delay： long distance between the site where stroke onset occurred and hospital, long time in out-patient room. Conclusions The phenomena of hospitalization delay is especially common and there is a low treatment rate of thrombolysis therapy in ischemic stroke. The main reason of hospitalization delay lies in ignorance of relevant risk factors, clinical symptoms of stroke and using emergence system sufficiently.