鄂尔多斯地区脑梗死患者院前时间的研究

目的探讨鄂尔多斯地区脑梗死患者院前时间和影响因素。方法前瞻性连续登记2012年1月1日至2014年5月31日期间因脑梗死入院的患者,采用问卷和访视调查方法调查院前时间及相关因素。结果共纳入320例脑梗死患者,其中24例(7.5%)症状出现后2 h内到达医院,92例(28.75%)发病2 h内做出就医决定(早期就医决定组),228例(71.25%)发病2 h后做出就医决定(延误决定就医组),早期决定就医对院前时间影响有统计学意义(P0.001),但两组转送时间差异无统计学意义(P=0.924),是否使用120救护车对院前时间影响有统计学意义(P0.001),发病时是否求助诊所医师对院前时间影响无统计学意义(P=0.182)。结论本地区脑梗死院前延误非常严重,就医决定延误是主要原因,不能充分利用救护车也是重要原因,普及本地区居民卒中知识、提倡使用救护车及改善医院布局可使脑梗死患者获益。

Study of prehospital time in patients with cerebral infarction: findings from Erdos, China

Objective To investigate the prehospital time and influencing factors in patients with cerebral infarction in Erdos, China.Methods Hospitalized patients with cerebral infarction were consecutively and prospectively registered from January 1, 2012 to May 31, 2014. Questionnaires and interviews were used to investigate the prehospital time and its associated factors.Results A total of 320 patients with cerebral infarction were enrolled, among which 24 patients (7.5%) arrived at the hospital within 2 hours after symptom onset, 92 patients (28.75%) made decision to seek medical help within 2 hours after symptom onset (early decision group), and 228 patients (71.25%) made decision to seek medical help more than 2 hours after symptom onset (delayed decision group). Early decision made a significant difference for prehospital time (P<0.001), but there was no significant difference in transport time between the two groups (P=0.924). Whether to use ambulance or not differed significantly for prehospital time (P<0.001). There was no significant difference in turning to the clinic doctors (P=0182).Conclusions Prehospital delay in patients with cerebral infarction is very heavy in this area, with delayed decision as the main reason and not making full use of ambulance as another. It is beneficial for patients with cerebral infarction to popularize knowledge of cerebral infarction among local residents, promote the use of ambulance, and improve the layout of hospitals.