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目的研究内蒙古地区蒙古族人群缺血性脑卒中患者二级预防实施情况及影响因素。方法调查2013年6月1日—2014年12月31日在内蒙古自治区人民医院住院诊治的蒙古族新发缺血性脑卒中患者,在办理出院1年后,电话随访获取患者的就诊行为及用药等信息。结果研究期间共入选有效病例152例,有效随访136例,失访率为10.5%。规律复诊组42例,抗栓药物、降血糖药物、降血压药物及他汀类药物的实用率分别为82.9%、90.0%、88.9%及77.5%;非规律复诊组94例,分别为12.1%、31.3%、16.1%及12.7%。2组间差异均有统计学意义(P<0.05)。非规律复诊的主要原因包括:不知道二级预防重要性为42.6%、无医保或无经济能力为33.0%、医生未告知为10.6%、无家人陪同或行动不便为12.8%,其他为1.0%。结论内蒙古地区蒙古族人群缺血性脑卒中二级预防实施状况欠佳,主要影响因素为知识欠缺和经济落后。推进缺血性脑卒中健康教育,提高医保缴存率和特定病种报销比例,有助于改善缺血性脑卒中患者二级预防实施质量。
Objective To study the secondary prevention and its influential factors in Mongolian population with ischemic stroke in Inner Mongolia. Methods A survey of new Mongolian patients with ischemic stroke admitted to the People’s Hospital of Inner Mongolia Autonomous Region from June 1, 2013 to December 31, 2014 was conducted one year after the hospital discharge and telephone follow-up was used to obtain the patient’s medical treatment and medication And other information. Results A total of 152 valid cases were enrolled during the study period, 136 cases were followed up effectively and the rate of loss to follow up was 10.5%. In the regular referral group, the effective rates of antithrombotic drugs, hypoglycemic drugs, antihypertensive drugs and statins were 42.9%, 90.0%, 88.9% and 77.5%, respectively; 94 cases were non-regular referral group, accounting for 12.1% 31.3%, 16.1% and 12.7% respectively. The differences between the two groups were statistically significant (P <0.05). The main reasons for irregular follow-up include: Do not know the importance of secondary prevention was 42.6%, no medical insurance or no economic ability of 33.0%, the doctor did not inform 10.6%, no family members or 12.8% of mobility problems, the other was 1.0% . Conclusion Secondary prevention of ischemic stroke in Mongolian population in Inner Mongolia is poorly implemented. The main influencing factors are lack of knowledge and economic backwardness. To promote health education in ischemic stroke, improve the medical insurance deposit rate and reimbursement ratio of specific diseases, can help to improve the quality of secondary prevention in ischemic stroke patients.