缺血性脑卒中二级预防现状及基于互联网平台的应对策略  

Status of secondary prevention of ischemic stroke and countermeasures based on internet platform

作　　者：王心悦[1] 毛森林[2] 李瑞芝 尤辉煌 张炜东 WANG Xin-yue;MAO Sen-lin;LI Rui-zhi;YOU Hui-huang;ZHANG Wei-dong(Clinical Medicine,Grade 2017,Harbin Medical University,Harbin 150081,China;Department of Neurology,The Second Affiliated Hospital of Harbin Medical University,Harbin 150081,China;Computer Science and Technology,Grade 2017,Zhejiang Sci-Tech University,Hangzhou 310018,China)

机构地区：[1]哈尔滨医科大学,黑龙江哈尔滨150081 [2]哈尔滨医科大学附属第二医院神经内科,黑龙江哈尔滨150081 [3]浙江理工大学,浙江杭州310018

出　　处：《哈尔滨医科大学学报》2020年第6期612-616,共5页Journal of Harbin Medical University

基　　金：黑龙江省大学生创新创业训练计划项目(S202010226032)。

摘　　要：目的调查分析哈尔滨地区缺血性脑卒中二级预防现状,进一步探索改进脑卒中二级预防的策略。方法收集分析2018年9月~2019年9月于哈尔滨医科大学附属第二医院神经内科住院,确诊为急性缺血性脑卒中的380例患者为研究对象进行回顾性分析,采取电话随访或发送电子问卷的形式进行调查,对脑卒中危险因素、患者的服药情况和患者服药依从性进行分析。结果脑卒中患者危险因素中高血压占67.65%、糖尿病占39.41%、高血脂占49.41%,高盐饮食71.47%、吸烟28.24%、肥胖30.29%;高血压、高血脂、糖尿病控制的达标率分别为56.09%、44.05%、53.73%;长期规律服用抗栓药物者占44.41%,长期规律服用他汀类药物、降压药物、降糖药物者分别为32.94%、61.74%、43.82%;在服用药物依从性不好的主要原因有:担心出现药物的副作用、医生没有嘱咐疗程、症状好转后自行停药。结论脑卒中二级预防存在危险因素患病率高、生活方式不健康、"三高"控制达标率低、不能坚持服药的特点。需要加强宣教,并借助互联网平台的优势建立全程的二级预防方案,给予卒中患者出院后的全程管理指导。Objective To investigate and analyze the status of secondary prevention of ischemic stroke in Harbin, and to further explore strategies for improving secondary prevention of stroke. Methods From September 2018 to September 2019, 380 patients diagnosed as acute ischemic stroke in the Department of Neurology of the Second Affiliated Hospital of Harbin Medical University were selected as the research subjects. The current status of stroke risk factors, the patient’s medication intake and the patient’s medication compliance were investigated and analyzed by outpatient follow-up, telephone follow-up or sending an electronic questionnaire. Results Among the risk factors of stroke patients, hypertension accounted for 67.65%, diabetes accounted for 39.41%, hyperlipidemia accounted for 49.41%, high-salt diet accounted for 71.47%, smoking accounted for 28.24%, and obesity accounted for 30.29%;Control compliance rate of hypertension, hyperlipidemia, diabetes were 56.09%, 44.05%, 53.73%, respectively;44.41% of people who regularly took antithrombotic drugs for a long time, of people who regularly took statins, antihypertensive drugs, and hypoglycemic drugs were 32.94%, 61.74%, 43.82%, respectively;The main reasons for poor drug compliance were: worrying about the side effects of the drug, not informed by the doctor of the treatment course, and stopping the drug after the symptoms being improved. Conclusion There are high prevalence of risk factors, unhealthy lifestyle, low control rate of "three high" control, and failure to adhere to medication. It is necessary to strengthen propaganda and education, to establish the whole process of secondary prevention plan with the advantage of internet platform, and to give the whole process management guidance to stroke patients after discharge.

关 键 词：缺血性脑卒中 二级预防 对策 

分 类 号：R743.3[医药卫生—神经病学与精神病学]