重庆南部地区缺血性脑卒中二级预防现状

Secondary prevention situation of ischemic stroke in the southern of Chongqing

目的分析重庆南部地区缺血性脑卒中二级预防现状。方法通过软件抽样,了解10个街道和乡镇,2009年5月至2010年12月首次脑卒中,在重庆南部地区二级以上医疗机构住院,全部经CT/MRI证实,出院诊断为缺血性脑卒中的患者,回顾其治疗经过,了解其出院后对脑卒中危险因素知晓率、用药情况。结果 (1)出院1个月的患者,对危险因素知晓率明显高于随后的调查,随时间推移,患者知晓率有下降的趋势。但是患者对血糖、血脂、心脏病始终保持在比较恒定的知晓水平。而对血压、体重控制、戒烟限酒等生活习惯方面,知晓率有较大起伏。(2)特异药物选择比较随意,特别中成药、扩管药物、神经保护的大量使用,一方面使患者医疗费用耗费巨大,经济难以为继;另一方面患者对二级预防抓不住重点,使二级预防效果大打折扣;再者患者服药情况也不理想。结论患者对脑血管危险因素知晓率有待提高,用药有待规范。本次调查结果显示重庆南部地区二级预防工作非常严峻。

Objective To analyze the secondary prevention situation of ischemic stroke in the southern of Chongqing. Methods Sample investigation software is adopted to review the medical treatment experience,make a survey of knowing status and drug therapy of patients who suffer the ischemic stroke from May 2009 to Dec 2010 with confirmed diagnose as ischemic stroke through CT/MRI. Results （1）The awareness rate of risk factors of patients who discharge 1 month from hospital was higher than the patients who discharged hospital more than 1 month. The awareness rate was getting lower over time. However,the awareness rate for certain indexes, such as blood sugar, blood pressure and heart disease kept constant; the awareness rate for living habits, such as giving up smoking and drinking, were fluctuated. （2）Medicine mistaking especially for Chinese traditional patent medicine, vessels expanding and neuro-protection, may cause two negative consequences：（1）It may increase the treatment cost of patients. （2）It will impact the effectiveness of secondary prevention because patients cannot hold the key point of secondary prevention. （3）Patients cannot receive effective medicine. Conclusions The awareness rate risk factors need to be raised and the medicine therapy need to be improved. The secondary prevention situation in the southern of Chongqing faces server challenge.