| Objective: This paper mainly analyses the influence factors of in-hospital delayabout intravenous thrombolysis in patients with acute cerebral infarction.Methods: A retrospective study was conducted to collect 186 patients with acute cerebral infarction who were admitted through the stroke green channel and received rt-PA intravenous thrombolysis in the former 202 hospital from January 1,2016 to June 30,2017.According to the basic condition status of the patients and the completeness of relevant data at the consultation of the stroke physicians,the patients were divided into the integrity 1(the relevant information of the disease is complete enough to make the judgment of thrombolysis),integrity 2(the complete degree of disease related information is between 1 and 3),integrity 3(the stroke physicians and emergency physicians viewed the patients at the same time,and disease related information were 0),collecting and comparing the basic information of the patients [sex,age,hypertension history,diabetes history,coronary heart disease history,atrial fibrillation history,stroke history,smoking history] and observation index [NIHSS score before thrombolysis,proportion of typical clinical symptoms,biochemical examination comprehensive proportion,the auxiliary inspection detail proportion,pre-hospital time,time from hospital to consultation with a stroke physician and the time of consultation with a stroke physician to intravenous thrombolysis,60 min or less [cases(%)],good prognosis rate].According to door-to-needletime(DNT),the patients were divided into either a delay groupor a non-delay group,comparing the basic information [sex,age,hypertension history,diabetes history,coronary heart disease history,atrial fibrillation history,stroke history,smoking history],observation index [NIHSS score before thrombolysis,proportion of typical clinical symptoms,biochemical examination comprehensive proportion,the auxiliary inspection detail proportion,pre-hospital time,time from hospital to consultation with a stroke physician and time of consultation with a stroke physician to intravenous thrombolysis,60 min or less [cases(%)],good prognosis rate and the difference of stroke physician consultation related data integrity].Further,multivariate analysis was used to identify the independent risk factors for in-hospital delay in patients with acute cerebral infarction.Results: 1.Differences among different degrees of integrity: there were no statistically significant differences among the basic data,NIHSS score before thrombolysis and good prognosis rate in the three groups(all p > 0.05).There were statistically significant differences in the proportion of typical clinical symptoms,biochemical examination comprehensive proportion,the auxiliary inspection detail proportion,pre-hospital time,time from hospital to consultation with a stroke physician and time of consultation with a stroke physician to intravenous thrombolysis,and 60 min or less [cases(%)](all p <0.05).2.Differences betweenwhether in-hospital delay exists: in the group of non-delay and delay,there were statistically significant differences in the integrity,biochemical examination comprehensive proportion,the auxiliary inspection detail proportion,NIHSS score before thrombolysis,pre-hospital time,time from hospital to consultation with a stroke physician and time of consultation with a stroke physician to intravenous thrombolysis among these aspects of statistical significance(p < 0.05).However,there was no significant difference in the basic data,proportion of typical clinical symptoms and good prognosis rate(all p > 0.05).3.Influence factors: According to door-to-needle time,they were divided into a delay group and a non-delay group,analyzing the differences between the two groups by logistic regression analysis,finding that the completeness of relevant data during the consultation of stroke physicians and the time from arriving hospital to consultation with a stroke physician were independent influence factors for the delayed-hospital of patients with acute cerebral infarction.Conclusion: 1.Emergency physicians do most thrombolysis preparation or emergency physician and stroke physicians simultaneously accepts patients with acute cerebral infarction is faster than emergency physicians and stroke physicians working in tandem to prepare for thrombolysis.2.By comparing and analyzing the influence factors of in-hospital delayabout intravenous thrombolysis in patients with acute cerebral infarction,it was concluded that the difference in the completeness of the relevant data of patients at the consultation of stroke physicians and the time of the consultation of stroke physicians are independent influence factors.For patients with acute cerebral infarctionrequiring intravenous thrombolytic therapy,there is less possibility of in-hospital delay in direct admission by stroke physicians. |
PDF Full Text Request