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目的分析急性缺血性卒中患者就诊延迟因素,提高公众、特别是高危人群对急性脑卒中早期就诊和治疗重要性的认识。方法采用问卷调查的方法 ,连续收集2008年9月-2009年9月来我院就诊的550例急性脑卒中患者,采用单因素分析方法分析就诊延迟的相关因素。结果全部患者均经头颅CT或MRI证实。根据就诊时机将患者分为就诊及时组和就诊延迟组,及时就诊46例(8.4%),就诊延迟504例(91.6%)。就诊延迟患者中,3.5～24h内就诊131例(23.8%),24～72h就诊283例(51.5%),超过72h就诊136例(24.7%)。导致急性脑卒中患者就诊延迟的相关因素有发病时间、是否独居、首诊地点、转运方式、有无卒中病史、发病地点距首诊医院距离等因素,两组间比较有统计学意义(P<0.05),而性别、年龄、婚姻状况、文化水平、工作状况、医疗状况、是否知道自己属于卒中高危人群、美国国立卫生研究院卒中量表评分在两组间差异无统计学意义。结论导致急性脑卒中患者就诊延迟与发病时间、是否独居、首诊地点、转运方式、有无卒中病史、发病地点距首诊医院距离等因素有关。
OBJECTIVE: To analyze the delay of visits in patients with acute ischemic stroke and to raise awareness of the importance of early treatment and treatment of acute stroke in the public, especially at high risk. Methods A total of 550 patients with acute stroke admitted to our hospital from September 2008 to September 2009 were collected by questionnaire. The related factors of delayed treatment were analyzed by univariate analysis. Results All patients were confirmed by skull CT or MRI. According to the timing of treatment, patients were divided into treatment-timely group and treatment-delay group. 46 cases (8.4%) were treated promptly and 504 cases (91.6%) were delayed. Among the patients with delayed treatment, 131 (23.8%) were treated within 3.5 ~ 24h, 283 (51.5%) were treated within 24 ~ 72h, and 136 (24.7%) were treated more than 72h. The factors that led to the delay in the treatment of acute stroke patients were morbidity time, whether living alone, the place of first visit, mode of transport, history of stroke or not, the distance from the first hospital to the place where the disease was found, and the other two factors were statistically significant (P < 0.05). The gender, age, marital status, educational level, working status, medical status, whether they knew they were at high risk of stroke or not, and the NIH Stroke Scale score was not significantly different between the two groups. CONCLUSIONS: The factors contributing to the delay in the treatment of patients with acute stroke, such as the time of onset of illness, whether or not to live alone, the place of first visit, the mode of transport, the history of stroke, and the distance from the first hospital to the hospital for the diagnosis of acute stroke.