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目的分析镇江市急救中心救治的脑卒中患者的流行病学与院前救治规律,为院前更好救治脑卒中提供建议。方法采用回顾性研究方法,分析2011年1月1日～2011年12月31日期间镇江市急救中心救治的脑卒中患者的院前急救病历资料。结果共救治脑卒中患者797例,占同期院前急救人数的10.42%,其中(1)男女比例=1.32∶1;年龄20～101岁,男性平均(66.67±13.937)岁,女性平均(71.85±13.797)岁(P<0.01);发病率随年龄增长,70～79岁是最高发年龄段;既往史以高血压病史多见,占394例(49.4%);(2)发病人数在季节上无特征变化(P>0.05);1 d中7时到12时、16时至20时是两个高峰时间段,9时至10时最高发时段(共61例,占8.3%),而凌晨4时至5时的发病率最低(共9例,占1.4%);(3)全部病例中危重192例(24%),重症359例(45%),轻症246(31%);送三甲医院患者人数共为552例,占总人数的69.3%,以患方自主择院为主(626例,78%);(4)急救反应时间(接警至到达现场时间)平均13.49 min,其中10 min内共318例(39.9%);急救总耗时平均38.11 min。结论 (1)老年人是脑卒中发生的易患人群,应积极开展预防工作,特别是有高血压病的患者应注意监测和治疗高血压病;(2)脑卒中的救治过于集中于大医院,应积极构建脑血管病的急救、防治与康复的高度组织化的管理体系;(3)急救中心除了在脑卒中高危人群中普及脑卒中急救知识的同时应加强院前急救网络建设,提高院前急救质量。
Objective To analyze the epidemiology and pre-hospital treatment rules of stroke patients treated in the emergency center of Zhenjiang City, so as to provide suggestions for better prevention and treatment of stroke in the hospital. Methods A retrospective study was conducted to analyze the prehospital emergency medical records of stroke patients who were treated in Zhenjiang Emergency Center from January 1, 2011 to December 31, 2011. Results A total of 797 stroke patients were treated, accounting for 10.42% of the pre-hospital emergency numbers. Among them, (1) the male-female ratio was 1.32:1; the average age was 20- 101 years (66.67 ± 13.937) and the average female was 71.85 ± 13.797) years old (P <0.01). The morbidity increased with age and was the highest in 70-79 years old. The past history of hypertension was more common, accounting for 394 cases (49.4%). (2) There was no characteristic change (P> 0.05). From 1:00 to 7:00 to 12:00 and from 16:00 to 20:00, there were two peak periods, the highest period from 9:00 to 10:00 (61 cases, accounting for 8.3%), The morbidity was lowest at 4 o’clock to 5 o’clock (9 in all, accounting for 1.4%); (3) 192 (24%) were critically ill, 359 (45%) were severe and 246 (31%) were mild The number of patients in the top three hospitals was 552, accounting for 69.3% of the total number of patients, with 626 patients (78%) having voluntary hospitalization. (4) The average response time (alarm to arrival time) was 13.49 min A total of 318 cases (39.9%) within 10 min; the average time for first aid was 38.11 min. Conclusion (1) Elderly people are susceptible to stroke, and prevention should be actively carried out. In particular, patients with hypertension should pay attention to monitoring and treating hypertension. (2) The treatment of stroke is too concentrated in large hospitals , Should actively build a highly organized management system for the first aid, prevention and rehabilitation of cerebrovascular disease; (3) In addition to popularizing the knowledge of emergency stroke at high risk of stroke, emergency center should strengthen the construction of pre-hospital emergency network, First aid quality.