急性脑血管病患者到达医院治疗时间的分析

Evaluation of the factors leading to time from stroke onset to arrival at hospital

目的调查急性脑血管病发作至到达医院及开始治疗的时间,分析不同时间到达及治疗的相关因素。方法前瞻性调查624例急性脑血管病人发病至急诊,急诊至头颅CT,急诊至治疗时间并做卒中知识调查。结果发病后<3小时到达者18.27%、<6小时到达者39.9%、<12小时到达者60.2%、<24小时到达者83.9%,发病至急诊中位时间7.23小时。多元逐步回归分析:发病地点与医院间距离远,发病时症状轻、发病患者及家属不重视而首诊当地小诊所,发病时周围没人,没有使用急救车,病人对卒中的意识以及病人经济困难与到医院时间最为相关(P<0.05或P<0.001)。结论脑血管病人发病后到医院时间明显不同,需加强对公众的健康教育,提高急性脑血管病发作后的求救意识,尽可能使用急救车快速转至正规医院及时治疗。

Objective To investigate time from stroke onset to arrival at the emergency department and to evaluate the factors associated at various times.Methods In this prospective study,the factors influencing the time from stroke onset to patient arrival at the department and department-CT and access to department-treatment were explored in 624 patients with acute stroke.The data recorded included patients knowledge of stroke.Results 18.27% patients arrive within three hours,39.9% within six hours,60.2% within twelve hours,83.9% within twenty-four hours.The median time from onset to department was 7.23 hours.Stepwise regression analysis showed that significant risk factors relate to arrival delay included long distance from home to hospital,mild degree of neurological symptoms,less attention to the stroke onset,along at onset of the illness,no facility of ambulance transportation(P<0.05 or P<0.001).Conclusion There is significant time difference from stroke onset to patients arrival at the department.Further health education is necessary to increase the public awareness of seeking medical help after stroke onset and having ambulance transportation to acute-care hospital.