缺血性脑卒中患者院前转运情况对就诊时间的影响研究

Impact of Pre-hospital Transfer on Time to Admission of Ischemic Stroke Patients

目的探讨缺血性脑卒中患者院前转运的情况及其对就诊时间的影响。方法分析2011年7—12月神经内科收治的273例缺血性脑卒中患者的入院方式、转运方式及居住地对就诊时间的影响。结果 273例缺血性脑卒中患者的平均就诊时间为(40.9±4.1)h,6 h内就诊的有110例(40.3%)。首诊入院与转诊入院的患者就诊时间比较,差异有统计学意义(χ2=40.518,P<0.05);不同居住地的患者入院方式及就诊时间比较,差异均有统计学意义(χ2值分别为39.425和11.796,P<0.05);不同转运方式患者的就诊时间比较,差异有统计学意义(χ2=18.209,P<0.05)。私家车和出租车仍是患者就诊的首选转运方式,分别占45.8%和23.1%,而使用救护车转运的仅占4.7%。结论入院方式、转运方式会影响缺血性脑卒中患者的就诊时间。急救车使用率低,公众使用急救系统的意识有待提高。

Objective To explore the situation of ischemie stroke patients pre - hospital transfer and its impact on the time to admission. Methods The hospitalization mode, transfer mode, and residency and their impacts on time to admission were analyzed among 273 ischemic stroke patients who were treated in the department of neurology in our hospital from July 2011 to December 2012. Results Of these 273 patients, the average time to admission was （40. 9 ±4. 1 ） h, among whom 110 pa- tients （40. 3% ） were admitted within 6 hours after stroke onset. The time to admission significantly differed between the firstly - diagnosed patients and the referred patients （ X^2 =40. 518, P 〈0. 05 ）. Patients living in different areas also showed significantly different time to admission （ X^2 = 39. 425, 11. 796, P 〈 0. 05 ）. Patients who were transferred via different modes also had sig- nificantly different time to admission （X^2 = 18. 209, P 〈 0. 05 ）. Private cars and taxi remain the main transport methods, ac- counting for 45.8% and 23. 1%, respectively. The first aid system utilization rate was low, with only 4. 7% patients transferred using the ambulance. Conclusion Admission modes and transfer methods influence the timely management of patients with is- chemic stroke. The ambulance utilization rate remains low, and the general public＇s awareness of the first aid services needs to be improved.