某市急性脑卒中患者就诊时间及其影响因素分析

Abstract

目的：探讨某市急性脑卒中就诊时间及其影响因素。方法：收集2015年1月~2015年12月在急诊科就诊的首次发作的脑卒中患者646例，记录就诊时间、到达急诊科的方式，分析脑卒中类型、职业、文化程度及首发症状对就诊时间是否有影响。结果：646例患者中，仅17.8%的患者在发病 <2小时到达医院就诊，22.5%的患者在发病2~6小时到医院就诊，到达急诊室最常见的转运方式是公交车。脑出血、高中及以上文化程度、干部就诊时间 ≤6小时比例高。首发症状以癫痫发作、意识障碍、头痛以及 ≥3个症状的患者就诊时间短。结论：公众对脑卒中的识别能力低、急救意识差，院前急救模式不完善，应完善急救模式并加强对救护人员的脑卒中救治的规范化培训。 Objective: To study the visiting time of acute cerebral stroke patients in a city and its influencing factors. Methods: 646 acute cerebral stroke patients for initial attack who visited Emergency De-partment from January to December in 2015 were enrolled into this study. Their visiting time and ways of arriving at the Emergency Department were recorded. Effect of types of cerebral stroke, occupation, educations level and initial symptoms of the patients on their visiting time was analyzed. Results: In 646 patients, 17.8% and 22.5% of the patients had visiting time <2 h and 2 - 6 h, respectively, after the onset of disease. The patients usually went to hospital by bus. The proportions of patients with hemorrhagic cerebral stroke, graduated from senior middle school, cadres, technicians with a visiting time ≤6 h was higher. The visiting time of those with their initial symptoms ≥3 such as epilepsy, disturbance of consciousness and headache 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 imperfect. We should perfect the prehosptial first-aid system and enhance standard training for ambulance crews about first-aid of cerebral stroke.