| Objective: To analyze the factors related to prehospital and in hospital delays in management of acute ischemic stroke(AIS)and hospital delay related factors of stroke and the emergency services and arterial thrombolysis treatment in our hospital,to explore the possible solutions and strategies.Methods: A total of 149 patients with acute ischemic stroke were enrolled in the Department of Emergency Medicine,First Affiliated Hospital of Shihezi University from September 2015 to July 2016.The general information,risk factors,onset of acute ischemic stroke,3-month prognosis of stroke patients,Time of onset of acute ischemic stroke,the time of arrival to Shihezi University hospital,the time to reach the emergency department and then the arterial puncture time were noted..The patient who reach hospital emergency department within 5 hours and less than or equal to 5 hours after onset of stroke were placed in without delayed group,And who reached after 5 hours were divided into prehospital delay group.The single factor and multiple logistic regression analysis were used to analyze the delayed factors in patients with arterial thrombolytic therapy.In the univariate analysis,the chi-square test or t test was used according to whether the metrological data or the counting data were normal,P was less than 0.05 Statistically significant.While the actual hospital delay time with the United States National Institute of Neurological Diseases and Stroke(NINDS)international standard time t test or rank test,to reach the emergency department to stroke patients with arterial thrombosis when the arterial puncture time and intravascular treatment of the United States National(NINDS)international standard time t test or rank sum test,and calculate the prognosis of patients with acute ischemic stroke for 3 months.Results:(1)General information: 149 cases of acute ischemic stroke patients in which 143 cases were Han nationality,Hui were 5 cases,Kazak 1 case;105 males and 44 females;mean age(65.26 ± 11.24)years old.(2)Prehospital non-delayed group and pre-hospital delay group of patients with income levels,symptoms of dizziness,headache,immediate response after the onset of treatment to our hospital,patients with NIHSS and GCS score,ambulance arrival time(P <0.05),and there was no significant difference between the two groups(P <0.05)There is no significant difference between the two groups(P <0.05).(3)Logistic regression analysis showed that dizziness and headache were associated with preoptic delay(P<0.05).(4)Compared with the National Institute of Neurological and Stroke(NINDS),In addition to the waiting time,history collection time,check the time and to the hospital to accept the treatment time and NINDS standard time comparison values are higher than the international standard time,in addition to history collection time more than the differences were statistically significant(P<0.05).(5)Comparison of endovascular treatment standard time for treatment each time and blood vessels,in addition to get to the emergency room and CT scan time,arrived at the emergency room and CT out of the reporting period,more time are higher than the international standard time,the differences were statistically significant(P <0.05).(6)In received acute ischemic stroke patients,the prognosis was good in 77 cases,accounting for52.38%,poor prognosis of24 cases,accounting for 16.33%.Conclusion : 1.patients with acute ischemic stroke patients in the early onset of consciousness andapplication of emergency system is low;2.patients with acute ischemic stroke in delay and endovascular treatment delays are more serious,optimize emergency procedures and stroke Easy Access to shorten the pre hospital and in-hospital delay is important reaction time;the relatively slow 3.emergency medical service hospital emergency treatment,relatively timely,pre hospital rescue personnel,emergency doctors,stroke experts should cooperate with each other is important for early diagnosis and treatment of acute ischemic stroke. |
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