既往卒中及高危卒中住院患者对急性缺血性卒中溶栓治疗认识情况的调查

Awareness of thrombolytic therapy for acute ischemic stroke in inpatients with a history of stroke and with a high risk of stroke

目的调查神经内科住院患者中既往卒中以及有卒中危险因素者对缺血性卒中溶栓治疗及时间窗的认识情况。方法 2012年1月—8月,采用自制调查问卷,以面对面的方式,对连续在重庆医科大学附属第二医院神经内科住院的500名卒中高危患者(包括既往已发生卒中的患者)进行调查。结果共完成467份有效调查问卷。既往卒中及高危卒中住院患者对溶栓治疗的知晓率为16.1%(75/467),其中知晓治疗时间窗的比例为50.7%(38/75);56~70岁年龄组、高文化水平、高收入、能报告3个及以上卒中警示症状、既往有卒中者对溶栓治疗的认识水平较高,而未婚或丧偶、既往有卒中者对治疗时间窗的知晓率更高。多因素logistic回归分析发现溶栓治疗的认识水平与年龄、文化程度、对卒中警示症状的认识个数及既往卒中史独立相关,溶栓治疗时间窗的认识水平与婚姻状况及既往卒中史相关(P<0.05)。结论神经内科住院的卒中高危患者(包括既往有卒中病史者)对急性缺血性脑卒中溶栓治疗的认识水平较差,有必要加强对卒中高危患者的卒中健康教育。

Objective To explore the awareness of thrombolytic therapy for acute ischemic stroke in inpatients with a history of stroke and with a high risk of stroke. Methods From January to August 2012, using self-designed questionnaire, trained neurologists conducted the face to face investigation in 500 inpatients with a high risk of stroke, including those with a history of stroke in Department of Neurology in the Second Affiliated Hospital of Chongqing Medical University. Results A total of 467 valid questionnaires were recovered. Only 16.1% （75/467） patients were aware of thrombolytic therapy for acute stroke, of whom 50.7% （38/75） knew the time window of thrombolytic therapy. Awareness of thrombolytic therapy was higher in patients aged 56-70 years, with a higher level of education and income, and in those who knew at least 3 stroke warning signs and those with a history of stroke. While awareness of the time window of thrombolytic therapy was higher in those unmarried or widowed and with a history of stroke. Multiple logistic regression analysis showed that awareness of thrombolytic therapy was independently associated with age, education level, knowledge of stroke warning signs and a history of stroke; awareness of the time window was associated with marital status and a history of stroke （P〈0.05）. Conclusions Inpatients with a history of stroke and with a high risk of stroke in the Department of Neurology have poor awareness of thrombolytic therapy for acute ischemic stroke. It is necessary to improve the level of patients＇ knowledge about thrombolytic therapy for acute stroke by health education.