本文選題：腦卒中 + 院前延遲�。� 參考：《重慶醫(yī)科大學(xué)》2013年碩士論文

【摘要】：目的了解影響急性缺血性腦卒中患者延遲入院的相關(guān)因素，尋求能幫助減少院前延遲的方法。 方法于2012年4月至2012年10月連續(xù)對243例于重慶醫(yī)科大學(xué)附屬第二醫(yī)院神經(jīng)內(nèi)科住院的急性缺血性卒中患者進行調(diào)查。通過篩選，共有217例患者符合我們的標準，被納入研究。醫(yī)務(wù)人員采用自制的調(diào)查問卷，記錄患者的一般信息、起病情況、發(fā)病后的反應(yīng)及就診過程等因素。 結(jié)果所研究的217例患者平均年齡為（67.1±11.8）歲，所有患者從癥狀發(fā)生至尋求醫(yī)學(xué)幫助的中位數(shù)時間為10（3-30.5）h，從癥狀發(fā)生至到達醫(yī)院的中位數(shù)時間為12（3.5-48）h。單因素分析顯示：癥狀發(fā)生突然、起病后癥狀有波動、對卒中癥狀識別個數(shù)越多、最先發(fā)現(xiàn)癥狀的是他人、自己及他人意識到出現(xiàn)中風(fēng)、自覺癥狀嚴重及不能控制癥狀、認為需要緊急治療、尋求幫助時沒有猶豫、心情焦慮、發(fā)病后的反應(yīng)為尋求醫(yī)學(xué)幫助、首診醫(yī)生為120急救醫(yī)生等因素能幫助減少院前延遲（P＜0.05），而較重的癥狀（NHISS評分＞10分）能減少從癥狀發(fā)生至達到醫(yī)院的時間（P＜0.05）。多因素回歸分析顯示：患者發(fā)病后的即刻反應(yīng)為尋求醫(yī)學(xué)幫助、首診醫(yī)生為120急救醫(yī)生、他人意識到發(fā)生中風(fēng)及他人建議尋求醫(yī)學(xué)幫助與院前延遲的縮短有關(guān)。 結(jié)論通過以上研究，，我們得出結(jié)論：使公眾意識到卒中發(fā)生后積極尋求醫(yī)學(xué)幫助的益處，提高急救系統(tǒng)的使用率，廣泛的對卒中高危人群的家屬及護理人員進行安全教育，對急缺血性卒中患者的早期診斷與治療具有重要的意義。
[Abstract]:Objective to investigate the factors related to delayed admission to hospital in patients with acute ischemic stroke and to find ways to help reduce the delay in pre-hospital. Methods from April 2012 to October 2012, 243 patients with acute ischemic stroke in the Department of Neurology, second affiliated Hospital of Chongqing Medical University were investigated. A total of 217 patients met our criteria and were included in the study. A self-made questionnaire was used to record the general information of the patient, the onset of the disease, the reaction after the onset of the disease and the process of seeing a doctor. Results the mean age of 217 patients was 67.1 鹵11.8 years old. The median time from symptom onset to seeking medical help was 100.3-30.5h. the median time from symptom onset to hospital arrival was 123.5-48h. Univariate analysis showed that symptoms suddenly occurred and symptoms fluctuated after onset. The more the number of recognized stroke symptoms, the first to find the symptoms was others. Oneself and others were aware of the occurrence of stroke, conscious symptoms were serious and could not be controlled. Thinking that urgent treatment is needed, that there is no hesitation in seeking help, that the mood is anxious, and that the response after the onset of the disease is to seek medical help. The factors such as 120 first-aid doctors for the first visit can help to reduce the pre-hospital delay (P < 0.05), and the severe symptom (NHISS > 10) can reduce the time from the onset of symptoms to reaching the hospital (P < 0.05). Multivariate regression analysis showed that the immediate response of the patient was to seek medical help, and the first doctor was 120 emergency doctors. Others realized that stroke and other people's advice to seek medical help were related to the shortening of the pre-hospital delay. Conclusion based on the above studies, we conclude that the public should be aware of the benefits of seeking medical help after stroke, improve the utilization rate of emergency system, and widely educate the family members and nursing staff of high risk groups of stroke. It is of great significance for the early diagnosis and treatment of acute ischemic stroke.
【學(xué)位授予單位】：重慶醫(yī)科大學(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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