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中华卫生应急电子杂志 ›› 2019, Vol. 05 ›› Issue (04) : 211 -215. doi: 10.3877/cma.j.issn.2095-9133.2019.04.004

所属专题: 文献

论著

116例急性卒中患者院前流行病学特征
邱晨1,(), 吴敏1, 纪学颖1, 樊冬雪1, 潘鑫1, 何斌1   
  1. 1. 212003 江苏镇江,镇江市急救中心急救科
  • 收稿日期:2019-04-10 出版日期:2019-08-18
  • 通信作者: 邱晨
  • 基金资助:
    镇江市重点研发计划-社会发展项目(SH2016057)

Prehospital epidemiological characteristics of acute stroke: clinical analyses of 116 cases

Chen Qiu1,(), Min Wu1, Xueying Ji1, Dongxue Fan1, Xin Pan1, Bin He1   

  1. 1. Zhenjiang Emergency Medical Center, Zhenjiang 212003, China
  • Received:2019-04-10 Published:2019-08-18
  • Corresponding author: Chen Qiu
  • About author:
    Corresponding author: Qiu Chen, Email:
引用本文:

邱晨, 吴敏, 纪学颖, 樊冬雪, 潘鑫, 何斌. 116例急性卒中患者院前流行病学特征[J/OL]. 中华卫生应急电子杂志, 2019, 05(04): 211-215.

Chen Qiu, Min Wu, Xueying Ji, Dongxue Fan, Xin Pan, Bin He. Prehospital epidemiological characteristics of acute stroke: clinical analyses of 116 cases[J/OL]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2019, 05(04): 211-215.

目的

探讨镇江市急救中心救治的116例急性卒中患者的临床特征。

方法

回顾性分析2019年1月1日至3月31日镇江市急救中心收治的116例脑卒中患者的病历资料,其中男性73例,女性43例;年龄23~96岁,平均(55.1±14.0)岁。分析内容包括患者基本特征、格拉斯哥昏迷量表(GCS)评分、美国国立卫生研究院卒中量表(NIHSS)评分、送达医院时的生命体征等。

结果

青年脑卒中(年龄<45岁)占全部患者的22.4%,65岁以下患者占78.4%。卒中患者以男性居多(62.9%),城市居多(72.4%)。从卒中症状开始到到达医院的时间平均为27 h(范围为0.5~72 h)。40例患者(34.5%)在症状出现后4.5 h内(窗口期)到达有溶栓能力的医院。患者总体NIHSS为(15.71±7.52)分,出血性卒中患者[(17.54±7.54)分]高于缺血性卒中患者[(14±7.15)分](P<0.05)。所有脑卒中患者入院平均GCS评分为(12.12±3.35)分,缺血性卒中为(13.07±2.56)分,出血性卒中为[(11.11±3.80)分](P<0.05)。

结论

镇江市急救中心院前救治的卒中患者以65岁以下患者为主,男性居多,尽管患者意识水平尚可,但普遍病情较重,而且仅约1/3患者能短时间到达医院。因此,社会、媒体和医疗机构应积极的宣传,使人们提高对危险因素和卒中的认识。急救中心也应进一步提升相应的救治能力。

Objective

To investigate the clinical characteristics of acute stroke patients treated in Zhenjiang Emergency Center.

Methods

The medical records of all stroke patients treated in Zhenjiang Emergency Center from January 01 to March 31, 2019 were analyzed retrospectively. The basic characteristics of the patients, Glasgow coma scale (GCS) score, National Institutes of Health Stroke Scale (NIHSS) score and vital signs at hospital were analyzed.

Results

A total of 116 patients with an average age of 55.1±14.0 years were included. Among them, male aged 56.7±14.9 years and female 52.5±12.1 years. Young stroke (younger than 45 years old) accounted for 22.4% of all patients, and patients under 65 years old accounted for 78.4%. The majority of stroke patients were male (62.9%) and lived in urban (72.4%). The average time from the onset of stroke symptoms to arrival at the hospital was 27 hours (ranging from 0.5 to 72 hours). Forty patients (34.5%) arrived at thrombolytic hospitals within 4.5 hours (window period) of the onset of symptoms. The mean NIHSS of patients with hemorrhagic stroke (17.54±7.54) was significantly higher than that of patients with ischemic stroke (14±7.15) (P<0.05). The average GCS score of all stroke patients was 12.12 ±3.35, ischemic stroke was 13.07±2.56 and hemorrhagic stroke was 11.11±3.80 (P<0.05).

Conclusions

Most of the stroke patients treated before hospital in Zhenjiang Emergency Center are 65-year-old or younger men. although the level of consciousness of the patients is OK, the condition is generally serious and only about 1/3 of the patients can reach the hospital in a short time. Therefore, society, the media and medical institutions should actively promote awareness of risk factors and stroke. The first aid center should also further improve the corresponding treatment capacity.

表1 急性卒中患者基本特征
表2 院前救治的卒中患者从中风发病到达医院的时间间隔分析[例(%)]
表3 院前救治的卒中患者到达医院时的评分[例(%)]
表4 院前救治的卒中患者到达医院时的生命体征[例(%)]
表5 院前救治的卒中患者发病时间段、初发情况、发作时状态[例(%)]
1
Patne S, Chintale K.Study of clinical profile of stroke patients in rural tertiary health care centre[J].Int J Adv Med,2016,3(3):666-670.
2
Maaijwee NA, Rutten-Jacobs LC, Schaapsmeerders P,et al.Ischaemic stroke in young adults:risk factors and long-term consequences[J]. Nat Rev Neuro,2014,10(6):315-325.
3
Feigin VL, Krishnamurthi RV, Parmar P,et al.Update on the global burden of ischemic and hemorrhagic stroke in 1990-2013:the GBD 2013 study[J].Neuroepidemiology,2015,45(3):161-176.
4
Owolabi MO, Akarolo-Anthony S, Akinyemi R,et al.The burden of stroke in Africa: a glance at the present and a glimpse into the future: review article[J].Cardiovasc J Afr,2015,26(2 Suppl 1):S27-S38.
5
Ekeh B, Ogunniyi A, Isamade E,et al.Stroke mortality and its predictors in a Nigerian teaching hospital[J].Afr Health Sci,2015,15(1):74-81.
6
Fekadu G, Chelkeba L, Melaku T,et al.Pathological sub types and diagnostic protocols of stroke among adult patients admitted to jimma university medical center,South West Ethiopia[J].JNeuroNeuro,2018,9(4):466.
7
Sarkar D, Halder S, Saha B,et al.A study of stroke patients with respect to their clinical and demographic profile and outcome[J].IntJ Med Sci,2016,4(9):4061-4066.
8
Deresse B, Shaweno D.Epidemiology and in-hospital outcome of stroke in South Ethiopia[J].J Neurol Sci, 2015,355(1-2):138-142.
9
Manorenj S, Inturi S, Jyotsna B,et al.Prevalence,pattern,risk factors and outcome of stroke in women: a clinical study of 100 cases from a tertiary care center in South India[J].Int J Res in Med Sci,2016,4(6): 2388-2393.
10
Nkoke C, Lekoubou A, Balti E,et al.Stroke mortality and its determinants in a resource-limited setting: A prospective cohort study in Yaounde,Cameroon[J].J Neuro Sci,2015,358(1-2):113-117.
11
中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2014[J].中华神经内科杂志,2015,48 (4):246-257.
12
中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国脑出血诊治指南(2014) [J].中华神经内科杂志,2015,48(6):435-444.
13
Pride GL, Fraser JF, Gupta R,et al.Prehospital care delivery and triage of stroke with emergent large vessel occlusion(ELVO):report of the standards and guidelines committee of the Society of Neurointerventional Surgery[J].J Neurointerv Surg,2017,9(8):802-810.
14
Kuriakose C, Shifafiya MN, Tharakan NS,et al.A prospective study of clinical profile of stroke in a tertiary care hospital[J]. AsiJPharmace and Cli Res,2016,9(3):1-4.
15
Writing Group Members, Mozaffarian D, Benjamin EJ,et al.Heart Disease and Stroke Statistics-2016 Update:A Report From the American Heart Association[J].Circulation,2016,133(4):e38-360.
16
Sarkar D, Halder S, Saha B,et al.A study of stroke patients with respect to their clinical and demographic profile and outcome[J].Int J Res Med Sci,2016,4(9):4061-4066.
17
Gebremariam SA, Yang HS.Types,risk profiles,and outcomes of stroke patients in a tertiary teaching hospital in northern Ethiopia[J].eNeurological Sci,2016,3:41-47.
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