急性缺血性脑卒中患者延迟溶栓的影响因素研究进展
Research Progress on Influencing Factors of Delayed Thrombolysis in Patients with Acute Ischemic Stroke
DOI: 10.12677/ACM.2023.1371643, PDF,   
作者: 阿伊尼格尔·吐松, 玉素甫江·牙库甫*：新疆医科大学第一附属医院急诊创伤中心，新疆 乌鲁木齐
关键词: 缺血性脑卒中；静脉溶栓；延迟；影响因素；Acute Ischemic Stroke； Intravenous Thrombolysis； Delay； Influence Factor
摘要: 急性缺血性卒中为临床常见脑血管疾病，疾病具有发病急、症状危重、致残率高及死亡率高等特征，为临床致死疾病首位，成为危害机体健康首要公共卫生问题之一。溶栓是目前治疗急性脑卒中的有效措施，但受到时间窗限制，就医延迟是导致患者溶栓治疗不足和低效率的主要原因。卒中就医延迟风险因素众多，本研究主要从院前延迟及院内延迟2个层面对其进行综述，探讨影响急性缺血性脑卒中急救延迟相关危险因素，旨在为后续卒中就医延迟风险管理、实施综合有效的干预和风险防范措施提供依据，以缩短卒中患者就医时间，从而减少就医延迟发生。
Abstract: Acute ischemic stroke is a common clinical cerebrovascular disease, which has the characteristics of acute onset, critical symptoms, high disability rate and high mortality rate. It is the first clinically fatal disease, and has become one of the primary public health problems that harm the body’s health. Thrombolytic therapy is an effective measure in the treatment of acute stroke, but limited by the time window, delayed medical treatment is the main cause of insufficient and inefficient thrombolytic therapy for patients. There are many risk factors for delayed medical treatment for stroke. This study mainly reviews them from two aspects: pre-hospital delay and in-hospital delay, discusses the risk factors affecting delayed emergency treatment for acute ischemic stroke, and aims to provide basis for subsequent risk management of delayed medical treatment for stroke, implementation of comprehensive and effective intervention and risk prevention measures, so as to shorten the time for stroke patients to see a doctor thus reducing the occurrence of delayed medical treatment.
文章引用：阿伊尼格尔·吐松, 玉素甫江·牙库甫. 急性缺血性脑卒中患者延迟溶栓的影响因素研究进展[J]. 临床医学进展, 2023, 13(7): 11729-11734. https://doi.org/10.12677/ACM.2023.1371643

参考文献

[1] 杨微, 郑蕾蕾, 侯春香. 预见性护理在急性缺血性脑卒中患者中应用研究[J]. 中国药物与临床, 2021, 21(11): 1995- 1996.
[2] 杨珊珊, 何金爱, 郑冬香. 时间追踪联合流程优化在急性缺血性脑卒中病人静脉溶栓中的应用[J]. 护理研究, 2019, 33(14): 2470-2472.
[3] 《中国脑卒中防治报告》编写组. 《中国脑卒中防治报告2020》概要[J]. 中国脑血管病杂志, 2022, 19(2): 136-144.
[4] Go, A.S., Mozaffarian, D., Roger, V.L., et al. (2014) Heart Disease and Stroke Statistics-2014 Update: A Report from the American Heart Association. Circulation, 129, e28-e292.
[5] Grysiewicz, R.A., Thomas, K. and Pandey, D.K. (2008) Epidemiology of Ischemic and Hemorrhagic Stroke: Incidence, Prevalence, Mortality, and Risk Factors. Neurologic Clinics, 26, 871-895. [Google Scholar] [CrossRef] [PubMed]
[6] 梁宏艳, 李明, 惠文, 等. 急性缺血性卒中患者救治时间延迟的研究进展[J]. 中国脑血管病杂志, 2019, 16(12): 662-666.
[7] Lindsay, P., Furie, K.L., Davis, S.M., Donnan, G.A. and Norrving, B. (2014) World Stroke Organization Global Stroke Services Guidelines and Action Plan. International Journal of Stroke, 9, 4-11. [Google Scholar] [CrossRef] [PubMed]
[8] 何俐. 脑卒中高危人群筛查和干预试点项目技术方案简介[C]//2014年中国老年健康论坛论文集. 2014: 20-21.
[9] 高峰, 方海霞, 张萍. 急性缺血性脑卒中患者静脉溶栓给药前移方法的应用分析[J]. 中国老年保健医学, 2020, 18(1): 104-106.
[10] 何晶, 马琴, 范珊, 等. 急性缺血性脑卒中病人延迟就医与家庭动力学的相关性研究[J]. 护理研究, 2020, 34(2): 197-201.
[11] 尤黎明, 吴瑛. 内科护理学[M]. 第6版. 北京: 人民出版社, 2017: 832-839.
[12] 陈明. 急性缺血性卒中院内救治流程优化实践与评价[D]: [硕士学位论文]. 重庆: 中国人民解放军海军军医大学, 2017.
[13] 谭冉, 邓立普. 急性缺血性脑卒中损伤机制及其治疗药物研究新进展[J]. 医学食疗与健康, 2021, 19(18): 206-208.
[14] 郭娟. 早期静脉溶栓治疗急性缺血性脑卒中的疗效及对凝血功能的影响[J]. 血栓与止血学, 2021, 27(6): 960-961.
[15] 林萍. 动脉溶栓与静脉溶栓治疗急性脑梗死患者的效果比较[J]. 中国民康医学, 2021, 33(17): 119-121.
[16] 许东, 赵海燕, 马东明, 等. 基于磁共振动脉自旋标记技术指导的急性缺血性卒中静脉溶栓研究[J]. 中国卒中杂志, 2016, 11(12): 1030-1034.
[17] 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2018[J]. 中华神经科杂志, 2018, 51(9): 666-682.
[18] Fernandes, D. and Umasankar, U. (2016) Improving Door to Needle Time in Patients for Thrombolysis. BMJ Open Quality, 5, u212969.w5150. [Google Scholar] [CrossRef] [PubMed]
[19] Wardlaw, J.M., Murray, V., Berge, E., et al. (2012) Re-combinant Tissue Plasminogen Activator for Acute Ischaemic Stroke: An Updated Systematic Review and Me-ta-Analysis. The Lancet, 379, 2364-2372. [Google Scholar] [CrossRef] 
[20] 刘丽萍, 王伊龙, 郑华光, 等. 2009美国国际卒中会议纪要[J]. 中国卒中杂志, 2009, 4(4): 267-272.
[21] Danoun, O., Sachar, P. and Rajamani, K. (2018) Thrombolysis for Acute Ischemic Stroke after Protamine Reversal of Heparin. American Journal of Therapeutics, 25, e552-e554. [Google Scholar] [CrossRef] 
[22] Darehed, D., Blom, M., Glader, E.L., Niklasson, J., Norrving, B. and Eriksson, M. (2020) In-Hospital Delays in Stroke Thrombolysis: Every Minute Counts. Stroke, 51, 2536-2539. [Google Scholar] [CrossRef] 
[23] 徐安定, 丁燕, 李牧. 中国缺血性卒中早期静脉溶栓的现状、阻碍因素及改进策略[J]. 中国卒中杂志, 2014(6): 522-528.
[24] 王文, 朱曼璐, 王拥军, 等. 《中国心血管病报告2012》概要[J]. 中国循环杂志, 2013, 28(6): 408-412.
[25] 王振海, 谢柳青, 赵春梅, 等. 急性缺血性脑卒中患者院前及院内延迟因素调查研究[J]. 中国全科医学, 2012, 15(23): 2605-2608.
[26] Faiz, K.W., Sundseth, A., Thommessen, B. and Rønning, O.M. (2014) Reasons for Low Thrombolysis Rate in a Norwegian Is-chemic Stroke Population. Neurological Sciences, 35, 1977-1982. [Google Scholar] [CrossRef] [PubMed]
[27] 王梦琪. 青海地区急性脑卒中延迟就诊因素及相关预后分析[D]: [硕士学位论文]. 青海: 青海大学, 2019.
[28] 王明连. 探究急性脑卒中患者溶栓延迟原因[J]. 养生保健指南, 2021(26): 84.
[29] 骆福秀. 急性脑卒中患者溶栓延迟原因分析[J]. 国际感染病学(电子版), 2019, 8(4): 269-270.
[30] 陈霞, 范冬冬, 储友群, 等. 急性缺血性脑卒中患者静脉溶栓现况及院前延迟的影响因素分析[J]. 护理学报, 2016, 23(21): 1-4.
[31] 梁余航, 杨春超, 庞伟, 等. 湛江地区急性缺血性脑卒中静脉溶栓延迟患方因素调查分析[J]. 广东医科大学学报, 2017, 35(2): 122-125.
[32] 赵艺皓, 吉训明, 杨莘. 缺血性脑卒中患者溶栓院内延迟现状及其影响因素研究进展[J]. 中国护理管理, 2016, 16(1): 103-107.
[33] Qiang, H., Qing, F.M., Juan, F., et al. (2015) Factors Associated with In-Hospital Delay in Intravenous Thrombolysis for Acute Ischemic Stroke: Lessons from China. PLOS ONE, 10, e0143145. [Google Scholar] [CrossRef] [PubMed]
[34] Faiz, K.W., Sundseth, A., Thommessen, B. and Rønning, O.M. (2013) Prehospital Delay in Acute Stroke and TIA. Emergency Medicine Journal, 30, 669-674. [Google Scholar] [CrossRef] [PubMed]
[35] Ashraf, V.V., Maneesh, M., Praveenkumar, R., et al. (2015) Factors Delaying Hospital Arrival of Patients with Acute Stroke. Annals of Indian Academy of Neurology, 18, 162-166.
[36] Kim, Y.S., Park, S.S., Bae, H.J., et al. (2011) Stroke Awareness Decreases Prehospital Delay after Acute Ischemic Stroke in Korea. BMC Neurology, 11, Article No. 2. [Google Scholar] [CrossRef] [PubMed]
[37] Maestronia, A., Mandelli, C., Manganaro, D., et al. (2008) Factors Influencing Delay in Presentation for Acute Stroke in an Emergency Department in Milan, Italy. Emergency Medicine Journal, 25, 340-345. [Google Scholar] [CrossRef] [PubMed]

为你推荐