CAJ | 학술논문

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93.5 min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＞93.5 min组相比较,院内延迟时间≤93.5 min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),x2=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≤93.5 min的促进因素,入院至得到影像学结果时间(OR=0.956,95％CI0.920～0.993,P=0.019)和化验结果时间(OR=0.935,95％CI0.893 ～0.980,P=0.004)是院内延迟时间≤93.5 min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.
목적 탐토절강서남부지구(간칭절서남)정맥용전원내연지시간이급영향기연장적인소.방법 수집취진우절서남6가대형종합성의원적110례재4.5h내접수중조조직형섬용매원격활물(rt-PA)정맥용전치료적급성결혈성졸중환자,근거원내연지시간적평균치93.5 min장110례환자분성량조,비교량조환자적기선특점,통과Logistic회귀분석영향원내연지시간적상관인소.결과 원내연지시간위(93.5±34.2)min.여원내연지시간＞93.5 min조상비교,원내연지시간≤93.5 min조적원전연지시간(단위균위min)교장(97.8±47.2여76.5±41.0,t=2.506,P=0.014),흡연비례교소[26.7％(16/60)여46.0％(23/50),x2=4.455,P=0.035],입원지득도영상학화화험결과시간(min)교단(29.0±16.2여46.0±27.1,t=3.365,P=0.001;40.5±15.8여60.0±21.0,t=4.457,P=0.000).Logistic회귀분석현시,원전연지시간(OR=1.015,95％CI 1.006～1.025;P=0.042)시원내연지시간≤93.5 min적촉진인소,입원지득도영상학결과시간(OR=0.956,95％CI0.920～0.993,P=0.019)화화험결과시간(OR=0.935,95％CI0.893 ～0.980,P=0.004)시원내연지시간≤93.5 min적조애인소.결론 영향절서남지구정맥용전원내연지시간적주요인소시원전연지시간、입원지득도영상학화화험결과시간.
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),x2 =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.