摘要
目的探讨浙江西南部地区（简称浙西南）静脉溶栓院内延迟时间以及影响其延长的因素。方法收集就诊于浙西南6家大型综合性医院的110例在4．5h内接受重组组织型纤溶酶原激活物（rt-PA）静脉溶栓治疗的急性缺血性卒中患者，根据院内延迟时间的平均值93．5min将110例患者分成两组，比较两组患者的基线特点，通过Logistic回归分析影响院内延迟时间的相关因素。结果院内延迟时间为（93．5±34．2）min。与院内延迟时间〉93．5min组相比较，院内延迟时间≤93．5min组的院前延迟时间（单位均为min）较长（97．8±47．2与76．5±41．0，t=2．506，P=0．014），吸烟比例较少[26．7％（16／60）与46．0％（23／50），x^2=4．455，P=0．035]，入院至得到影像学和化验结果时间（min）较短（29．0±16．2与46．0±27．1，t=3．365，P=0．001；40．5±15．8与60．0±21．0，t=4．457，P=0．000）。Logistic回归分析显示，院前延迟时间（OR=1．015，95％CI 1．006—1．025；P=0．042）是院内延迟时间≤93．5min的促进因素，入院至得到影像学结果时间（OR=0．956，95％CI 0.920—0．993，P=0．019）和化验结果时间（OR=0．935，95％CI 0．893～0．980，P=0．004）是院内延迟时间≤93．5min的阻碍因素。结论影响浙西南地区静脉溶栓院内延迟时间的主要因素是院前延迟时间、入院至得到影像学和化验结果时间。
Objective To analyze the in-hospital delay in the thrombolytic treatment of stroke in southwest of Zhejiang province and to identify the factors influencing the in-hospital delay. Methods One hundred and ten ischemic stroke patients treated with recombinant tissue plasminogen activator within 4. 5 hours from stroke onset were enrolled in the present study. Based on the average of in-hospital delay, 110 cases were divided into 2 groups, and compared their baseline characteristics. Logistic regression analysis was used to determine the independent factors associated to in-hospital delay. Results The mean in-hospital delay was （93.5 ± 34. 2） minutes. Eighteen cases （16. 4% ）had in-hospital delay ≤60 minutes. As compared to the in-hospital delay 〉 93.5 minutes group, the pre-hospital delay of the in-hospital delay ≤93.5 minutes group was longer（ （97.8 ±47.2） minutes vs （76. 5 ±41. 0） minutes,t =2. 506,P = 0. 014 ）, smoking was relatively smaller（ 26. 7% （16/60）vs 46. 0% （23/50）, x^2 = 4. 455 ,P =0. 035 ）, delay in admission to the imaging result and delay in admission to the laboratory result were shorter （ （29.0 ± 16. 2 ） minutes vs （ 46. 0 ± 27.1 ） minutes, t = 3. 365, P = 0. 001 ; （ 40. 5 ± 15.8 ） minutes vs （ 60. 0 ± 21.0 ） minutes, t = 4. 457, P = 0. 000 ）. Multiple logistic regression analysis showed that the in-hospital delay ≤ 93.5 minutes was independently predicted by the pre-hospital delay （ OR = 1. 015,95% CI 1. 006=1. 025, P = 0. 042） , delay in admission to the imaging result （ OR = 0. 956,95 % CI 0. 920-0. 993, P = 0. 019 ） ,delay in admission to the laboratory result （ OR = 0. 935,95% CI 0. 893-0. 980, P = 0. 004 ）. Conclusion The main factors that affected in-hospital delay were the pre-hospital delay, delay in admission to the imaging result, delay in admission to the laboratory result.
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2013年第11期730-734,共5页
Chinese Journal of Neurology
基金
断江省科技厅公益技术研究社会发展项目（2011C33017）
