河北省缺血性脑卒中院内诊治时间分布研究

Study on the in-hospital diagnosis and treatment time in patients with ischemic stroke in Hebei Province

目的调查河北省急性缺血性脑卒中患者的院内诊治时间分布情况。方法收集并分析河北省急性缺血性脑卒中患者的院内诊治流程资料并与NINDS推荐时间进行比较。结果院内诊治中位时间104 min高于推荐的60 min(P<0.001);“完成头颅CT扫描-获取CT报告”中位时间30 min高于推荐的20 min(P<0.001);“获取头颅CT报告-开始治疗”中位时间43 min高于推荐的15 min(P<0.001)。通过EMS就诊患者院内诊治中位时间是101 min,低于未采用患者的104 min(P=0.01);三级医院院内诊治中位时间是105 min,迟于二级医院的99 min(P<0.05)。结论河北省急性缺血性脑卒中院内救治延迟现象严重。获取头颅CT报告到开始溶栓治疗这一环节是造成院内延迟的最主要环节。通过EMS就诊可以缩短院内救治时间;二级医院相比三级医院院内延迟情况较轻。

Objective To investigate the in-hospital diagnosis and treatment time for patients with acute ischemic stroke in Hebei Province.Methods The data of in-hospital diagnosis and treatment of acute ischemic stroke in Hebei Province were collected and analyzed,and then compared with the NINDS recommended time.Methods The data of in-hospital diagnosis and treatment of acute ischemic stroke in Hebei Province were collected and analyzed,and then compared with the NINDS recommended time.Results The median time in hospital diagnosis and treatment was significantly longer than the NINDS recommended time(104 min vs.60 min,P<0.001).The median time from completing the cranial CT scan to getting the CT report differed signifi cantly to the NINDS recommended time(30 min vs.20 min,P<0.001).The median time from getting the CT report to obtaining treatment was 43 min,which was signifi cantly longer than the NINDS recommended 15 min(P<0.001).The median time of in-hospital diagnosis and treatment for emergency service system(EMS)patients was 101 min,which was shorter than that for non-EMS patients(104 min,P=0.01).The median time of in-hospital diagnosis and treatment in Tertiary Hospital was 105 min,which was signifi cantly longer than that in Secondary Hospital 99 min,(P<0.05).Conclusions The in-hospital emergency treatment delay in Hebei Province was relatively serious for patients with acute ischemic stroke.The time between obtaining the head CT report to beginning thrombolytic therapy is the most important factor in hospital delay.EMS can shorten in-hospital delay for acute ischemic stroke.Compared with the tertiary hospital,the secondary hospital has shorter in-hospital delay time.