院前家庭急救对出血性脑卒中预后的影响

A study on family first aid affecting the prognosis of patients with hemorrhagic stroke

目的探讨院前家庭急救对出血性脑卒中患者30d预后的影响。方法采用前瞻性队列研究,患者预后根据改良Rankin指数,分为预后良好(Rankin≤2)和预后不良(包括Rankin>2及死亡);家庭急救分为急救得当和急救不当。收集包括家庭急救及可能影响预后的有关指标资料,对指标与30d预后的关系进行单因素和多因素Logistic回归分析。结果79例出血性脑卒中病例进入研究,其中预后良好23例,预后不良56例;家庭急救措施得当37例,不当42例。Logistic逐步回归分析显示,家庭急救是出血性脑卒中预后的独立影响因素(OR=5.258)。结论家庭急救是院前急救中的重要环节。家庭急救不当是出血性脑卒中不良预后的危险因子。开展大众家庭急救教育,提高家庭急救技能,可以改善患者预后。

Objective To reveal the influence of family first aid on the 30-day prognosis of patients with hemorrhagic stroke. Methods Prospective cohort study was carried out. According to the modified Rankin index,the prognosis of patients was rated as good（Ranking〈2） and bad（including Rankin〉2 and death）. Family first aid was rated as no error and error. Related indexes including family first aid in patients with hemorrhagic stroke were collected. Singer factor analysis and Logistic regression analysis were done to analyze the relationship between these factors and 30-day prognosis. Results Among 79 patients with hemorrhagic stroke, 23 cases obtained good prognosis and 56 cases bad prognosis. There were 42 cases with family first aid errors and 37 cases no errors. Family first aid was a dependent influencing factor（OR=5.258）on the 30-day prognosis of patients with hemorrhagic stroke according to the result of Logistic stepwise regression analysis. Conclusions It is very important that the patients with hemorrhagic stroke be treated correctly before hospitalization. Family first aid error is a risk factor of the bad 30-day prognosis of patients. The prognosis of the patients with hemorrhagic stroke could be improved through promoting the lever of knowledge and skill of people.