新疆石河子地区急性脑卒中患者就诊时间及预后分析

摘要

目的：探讨新疆石河子地区急性脑卒中患者就诊时间及就诊时间对预后的影响。方法：收集2010~2011年石河子大学医学院第一附属医院急诊科及神经外科收治的1692例重症脑卒中患者，对其就诊时间以及与预后相关性进行分析。结果：6h 内的就诊率为41.12%，≥6h就诊率为62.89%，≥6h就诊率出血38.79%，缺血33.84%，平均就诊时间为13.4 h；知识的知晓性（值=0.003）、就诊率（值=0.008）、就诊方式（值=0.006）、有无高血压史及依从性（值=0.010）、疾病类型（值=0.037）、疾病严重程度（值=0.007）与及时就诊率相关；脑梗死患者男性发病(63.46%）明显多于女性（36.46%），脑出血患者男性(60.75%)发病例数多于女性(39.25%），差异有统计学意义（＜0.01）；脑梗死、脑出血患者发病有明显的昼夜及季节规律；治疗后无变化早期就诊组为30.4%，高于延迟就诊组(21.5%)；早期就诊组治疗后恶化率为10.9%，低于延迟就诊组(17.0%)，差异有统计学意义（＜0.05），显示就诊时间与预后有着显著相关性。结论：提高公众对此类疾病的认知程度，提高三级预防，做到早发现早诊断早治疗，可降低脑卒中患者的死亡率，减轻残废，从而提高患者的生活质量。%Objective: To investigate the visiting time of acute stroke patients and the effect of visiting time on the prognosis in Shihezi city,Xinjiang Province.Method: 1 692 cases of severe stroke patients in the Emergency and Neurosurgery department of the First Affiliated Hospital of Shihezi University School of Medicine from 2010 to 2011 were collected to analysis their visiting time and its correlation with prognosis.Results:The attendance rate within 6 hours is 41.12%,beyond 6 hours is 62.89%,the hemorrhage rate of patients whose visiting time beyond 6 hours is 38.79%, and the ischemia rate is 33.84%, the average visiting time 13.4 h;The awareness of knowledge ( =0.003),attendance rate(P=0.008),visiting way( =0.006),with or without hypertension and compliance ( =0.010), disease type ( =0.037), disease severity ( =0.007) are in correlation with timely visiting;The of male patients with cerebral ischemia is 63.46%,which is more than female patients with morbidity of 36.46%,incidence cases of male cerebral hemorrhage patients is 60.75%,more than female patients of 39.25%,and the difference is significant with value less than 0.01;The incidences of cerebral ischemia and cerebral hemorrhage are of obvious diurnal and seasonal patterns;30.4% of timely visiting groups received no change after treatment,the recovery rate is higher than delayed visiting groups with 21.5%.The deterioration rate of timely visiting groups is 10.9%, less than delayed visiting groups with 17.0%,and the difference is significant with value less than 0.05,the results showed that visiting time is correlated with prognosis.Conclusion:Enhancement of public awareness of these diseases and improvement of tertiary prevention as well as early detection,early diagnosis and early treatment can reduce mortality in patients with stroke; reduce disability,thereby improving the quality of life of patients.