脑卒中相关症状与院前延迟的相关性研究

Correlation Between Stroke-related Symptoms and Prehospital Delay

目的探索脑卒中相关症状的识别及其对急性缺血性脑卒中院前延迟的影响。方法连续纳入2015年1-12月在成都军区总医院就诊的539例急性缺血性脑卒中患者,通过面对面问卷调查方式采集数据,采用单因素分析及Logistic回归分析院前延迟相关因素。结果 91例(16.88%)患者在症状发生后早期(≤3.5h)到达医院就诊,其中下肢无力识别率最高(84.64%),面瘫识别率最低(13.30%);恶心呕吐(OR=13.364,P<0.001)和就医决定时间>60min(OR=181.945,P<0.001)是延迟就诊的独立危险因素;家人识别症状(OR=0.091,P<0.001)及上肢无力(OR=0.268,P=0.005)与早期就诊密切相关。结论脑卒中相关症状与院前延迟密切相关,应加强健康宣教以提高患者对卒中相关症状的识别率。

Objectives To explore the recognition of stroke related symptoms and their effect on the prehospital delay in acute ischemic stroke. Methods A total of 539 patients with acute ischemic stroke treated consecutively in Chengdu Military General Hospital from January to December of 2015 were enrelled in the study. The data collected by the face to face questionnaire survey were analyzed by single factor analysis and Logistic regression analysis to explore the related factors of prehospital delay. Results ninty one patients （16.88%） arrived at hospital within 3.5 hours after onset. Among those patients, the weakness of the lower limb was well recognized and the recognition rate was 84.64% , while the facial paralysis was poorly recognized and the recognition was 13.30%. Nausea and vomiting （OR=13. 364, P〈0.001） and over 60 minute decision time for medical treatment （OR=181. 945, P 〈 0. 001） were the independent risk factors of delayed treatment. The family members＇ recognition of symptoms （OR=0.091, P〈0.001） and the weakness of upper limbs （OR=0.268, P=0.005） were closely correlated with early treatment. Conclusion The stroke related symptoms were correlated with the prehospital delay. The health education should be strengthened to improve patients＇ recognition rate of stroke related symptoms.