作者：曾翔 ，李军文 ，王昆 ，郭雅乐 ，王兆兰

单位：

1.610095四川省成都市，成都医学院　2.610095四川省成都市第一人民医院护理部　3.610075四川省成都市，成都中 医药大学

Units：

1.Chengdu Medical College, Chengdu 610095, China 2.Nursing Department, Chengdu First People's Hospital, Chengdu 610095, China 3.Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China

关键词：

卒中；院前延迟；中国；Meta分析

Keywords：

Stroke; Prehospital delay; China; Meta-analysis

CLC：

R 743

DOI：

10.12114/j.issn.1008-5971.2023.00.312

Funds：

四川省科学技术厅2022年重点研发计划项目（22KJPX0117）

摘要：

目的　通过Meta分析探讨我国急性缺血性脑卒中患者院前延迟的影响因素。方法　计算机检索中国知 网、万方数据知识服务平台、维普网、中国生物医学文献数据库、PubMed、Web of Science、Cochrane Library公开发表 的关于中国急性缺血性脑卒中患者院前延迟相关因素或影响因素的文献，检索时间为建库至2023年5月，并手工检索 所有纳入文献的参考文献。由两名研究人员独立进行文献筛选和资料提取，由两名研究人员采用纽卡斯尔-渥太华量 表（NOS）评价文献的质量。使用Stata 12.0软件进行Meta分析。结果　经过筛选后最终纳入17篇文献，共包括5 769例 急性缺血性脑卒中患者，其中延迟组2 958例、非延迟组2 811例；各文献的NOS评分为6～8分。Meta分析结果显示，独 居〔OR=2.116，95%CI（1.726，2.595）〕、缺乏脑卒中疾病相关知识〔OR=2.008，95%CI（1.564，2.579）〕、居住 地为农村〔OR=3.278，95%CI（1.909，5.627）〕、转运方式为非救护车〔OR=5.242，95%CI（3.377，8.138）〕、无 心房颤动史〔OR=1.993，95%CI（1.438，2.763）〕、转诊〔OR=3.686，95%CI（2.197，6.185）〕是中国急性缺血性 脑卒中患者院前延迟的危险因素（P＜0.05）。敏感性分析结果显示，除美国国立卫生研究院卒中量表（NIHSS）评分 外，其他影响因素的Meta分析结果未发生明显改变。Egger's检验结果显示，报道独居、缺乏脑卒中疾病相关知识、居 住地为农村、NIHSS评分的文献间存在发表偏倚（P＜0.05），报道转运方式为非救护车、无心房颤动史、转诊的文献 间不存在发表偏倚（P＞0.05）。结论　独居、缺乏脑卒中疾病相关知识、居住地为农村、转运方式为非救护车、无心 房颤动史、转诊是中国急性缺血性脑卒中患者院前延迟的危险因素。

Abstract：

Objective To explore the influencing factors of prehospital delay in Chinese patients with acute ischemic stroke through meta-analysis. Methods A computer search was conducted for literature on related factors or influencing factors of prehospital delay in Chinese patients with acute ischemic stroke published by CNKI, Wanfang Data, VIP, Chinese Biomedical Database, PubMed, Web of Science and Cochrane Library. The retrieval time was from the establishment of the database to May All references included in the study were manually searched. Literature screening and data extraction were conducted independently by two researchers. The quality of the literature was evaluated using the Newcastle-Ottawa Scale (NOS) by two investigators. Meta-analysis was performed using Stata 12.0 software. Results After screening, 17 literature were finally included, including 5 769 patients with acute ischemic stroke, including 2 958 patients in the delayed group and 2 811 patients in the non-delayed group. The NOS scores of all literature ranged from 6 to 8. The results of meta-analysis showed that living alone [OR=2.116, 95%CI (1.726, 2.595) ] , lack of knowledge about stroke diseases [OR=2.008, 95%CI (1.564, 2.579) ] , rural residence [OR=3.278, 95%CI (1.909, 5.627) ] , non-ambulance transport mode [OR=5.242, 95%CI (3.377, 8.138) ] , no history of atrial fibrillation [OR=1.993, 95%CI (1.438, 2.763) ] , and referral [OR=3.686, 95%CI (2.197, 6.185) ] were risk factors for prehospital delay in Chinese patients with acute ischemic stroke (P < 0.05) . Sensitivity analysis results showed that meta-analysis results of other influencing factors did not significantly change except National Institutes of Health Stroke Scale (NIHSS) score. Egger's test results showed that there was publication bias among literature reporting living alone, lack of knowledge about stroke diseases, rural residence, and NIHSS score (P < 0.05) , while there was no publication bias among literature reporting non-ambulance transport mode, no history of atrial fibrillation, and referral (P > 0.05) . Conclusion Living alone, lack of knowledge about stroke diseases, rural residence, non-ambulance transport mode, no history of atrial fibrillation, and referral are risk factors for prehospital delay in Chinese patients with acute ischemic stroke.

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