本文選題：腦卒中 + 溶栓治療��； 參考：《華中科技大學(xué)》2013年碩士論文

【摘要】：目的： 調(diào)查武漢市部分三級醫(yī)院急性腦卒中患者的院前延遲時(shí)間分布情況，并分析其影響因素。 方法： 對2011年7月至2012年3月武漢市11家三級醫(yī)院663例急性腦卒中患者及家屬進(jìn)行問卷調(diào)查。調(diào)查的內(nèi)容包括患者的社會(huì)人口學(xué)資料、臨床特征、卒中癥狀認(rèn)知情況、起病后的就醫(yī)行為、院前時(shí)間。按癥狀出現(xiàn)4小時(shí)內(nèi)是否入院將其分為延遲組和非延遲組，采用單因素和多因素Logistic回歸分析法分析上述因素與院前延遲的相關(guān)性。 結(jié)果： 共調(diào)查了663例急性腦卒中患者，所有患者均經(jīng)神經(jīng)專科檢查和影像學(xué)檢查如頭部CT或MRI檢查后臨床診斷為急性腦卒中。(1)患者年齡中位數(shù)為63.1(12-99)歲；(2)男性有451人，占68.0%；(3)急性腦梗死患者有450例，占67.9%；(4)居住在城區(qū)者有384例，占57.9%；(5)在家中發(fā)病者有566例，占85.4%；(6)既往有腦卒中史的患者有151例，占22.8%；(7)出現(xiàn)癥狀后有291名患者立即就醫(yī)，占43.9%；(8)有194名患者是用救護(hù)車轉(zhuǎn)運(yùn)入院，占29.3%；(9)發(fā)病后4h內(nèi)入院的患者有315名，，占47.5%；(10)多因素Logistic回歸分析顯示：居住地點(diǎn)、有無腦卒中史、入院的轉(zhuǎn)運(yùn)方式和卒中癥狀認(rèn)知度是影響患者是否能在4小時(shí)內(nèi)到達(dá)醫(yī)院的獨(dú)立因素。 結(jié)論： 1.卒中知識(shí)缺乏；2.周邊醫(yī)療條件差；3.不會(huì)使用120急救系統(tǒng)；4.缺乏交通工具；5.社會(huì)卒中急救系統(tǒng)不夠完善等可能為院前延誤因素，需要患者、家屬、醫(yī)務(wù)工作者及社會(huì)共同努力，縮短院前延遲時(shí)間。
[Abstract]:Objective: To investigate the distribution of pre-hospital delay time in acute stroke patients in some tertiary hospitals in Wuhan and analyze its influencing factors. Methods: From July 2011 to March 2012, a questionnaire survey was conducted on 663 acute stroke patients and their families in 11 tertiary hospitals in Wuhan. The contents of the investigation included the social demographic data, clinical characteristics, cognitive status of stroke symptoms, medical behavior after onset, and pre-hospital time. The patients were divided into delayed group and non-delayed group according to whether they were admitted to hospital within 4 hours after the onset of symptoms. Univariate and multivariate Logistic regression analysis was used to analyze the correlation between the above factors and pre-hospital delay. Results: A total of 663 patients with acute stroke were investigated. The median age of all patients with acute stroke was 63.1 years (12-99) years old) and 451 men were clinically diagnosed as acute cerebral apoplexy after neuroimaging and CT or MRI examinations. There were 450 patients with acute cerebral infarction and 67.9 patients with acute cerebral infarction. There were 384 patients living in urban areas and 57.9patients living in urban areas. There were 566 patients at home, accounting for 85.4patients. There were 151 patients with a history of stroke, accounting for 22.87patients. (43.9%) 194 patients were transported to hospital by ambulance, 315patients were admitted to hospital within 4 hours after the onset of the disease, accounting for 47.5%) multivariate Logistic regression analysis showed that: place of residence, history of stroke, The mode of transport and the degree of recognition of stroke symptoms are independent factors affecting the patient's ability to reach the hospital within 4 hours. Conclusion: 1. Stroke knowledge is deficient. The peripheral medical conditions are poor. No 120 emergency systems will be used. Lack of transportation. The lack of perfect emergency system of social apoplexy may be the factor of delay before hospital, which needs the joint efforts of patients, family members, medical workers and society to shorten the delay time before hospital.
【學(xué)位授予單位】：華中科技大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R743.3

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