广州医药2025，Vol.56Issue(5)：630-637,643,9.DOI:10.20223/j.cnki.1000-8535.2025.05.008
急性脑梗死静脉溶栓决策延迟影响因素
Factors influencing decision delays in intravenous thrombolysis for acute ischemic stroke
苏钦坡 1王杰华 1陈渊洁1
作者信息
- 1. 泉州市第一医院神经内科(福建 泉州 362300)
- 折叠
摘要
Abstract
Objective To investigate the factors influencing delays in decision-making for intravenous thrombolysis with recombinant tissue plasminogen activator(rt-PA)in patients with acute cerebral infarction and to propose recommendations for reducing thrombolysis decision-making time.Methods A retrospective analysis was conducted on data from 120 patients with acute cerebral infarction admitted to the emergency department at Quanzhou First Hospital in 2023,including information from their families.Patients were divided into non-delay group(62 cases)and delay group(58 cases)based on a 5-minute threshold for thrombolysis decision-making time.Comparative analysis between the two groups was performed using SPSS 23.0 statistical software,with t-tests for continuous variables and χ2 tests for categorical variables.Logistic regression analysis was employed to identify risk factors affecting decision-making for intravenous thrombolysis in these patients.Results Statistical analysis revealed significant differences between the two groups in terms of native region,history of coronary heart disease,transfer from other hospitals,time from onset to hospital admission,and number of family members involved in decision-making(P＜0.05).Multivariate Logistic regression identified independent risk factors for delayed treatment decisions:non-Quanzhou native region(OR[95%CI]:9.29[2.21-38.97],P=0.002),having two or more decision-making family members(OR[95%CI]:18.73[5.96-58.80],P＜0.001),transfer from other hospitals(OR[95%CI]:10.26[2.09-50.42],P=0.004),and a time from onset to hospital admission of 3-4.5 hours(OR[95%CI]:4.09[1.45-11.48],P=0.008).Conclusions Factors such as non-Quanzhou native region,transfer from other hospitals,having two or more family members involved in decision-making,and a time from onset to hospital admission of 3-4.5 hours are associated with delays in thrombolysis decision-making.Optimizing the emergency rescue process for stroke and shortening the thrombolytic decision-making time through stroke education are suggested.关键词
急性脑梗死/静脉溶栓/溶栓决策/决策延迟Key words
acute cerebral infarction/intravenous thrombolysis/thrombolysis decision-making/decision-making delay引用本文复制引用
苏钦坡,王杰华,陈渊洁..急性脑梗死静脉溶栓决策延迟影响因素[J].广州医药,2025,56(5):630-637,643,9.
