某医院2015-2016年肝细胞癌患者就医延迟现状及其影响因素调查  

Investigation of Medical Delays in Hepatocellular Carcinoma Patients in 2016 and Influencing Factors

作　　者：王斌[1] 袁志林 

机构地区：[1]西安航天总医院肝胆外科,西安710100

出　　处：《解放军预防医学杂志》2017年第10期1294-1297,共4页Journal of Preventive Medicine of Chinese People's Liberation Army

基　　金：陕西省教育厅专项科研资助项目(No.15JK1617)

摘　　要：目的探讨肝细胞癌患者就医延迟现状及其影响因素。方法收集本院2015年-2016年收治的189例肝细胞癌患者的临床资料及随访资料,采用Logistic回归分析模型探讨影响肝细胞癌患者就医延迟的因素。结果 189例肝细胞癌患者中就医延迟49例(25.93%);通过分析影响肝细胞癌患者就医延迟的单因素显示:患者性别、婚姻状况、文化程度、慢性病毒性肝炎病史、肝癌家族史与肝细胞癌患者就医延迟影响因素无统计学意义(P>0.05);患者年龄、居住地、人均月收入、付费方式、是否知晓慢性病毒性肝炎随访检查情况与肝细胞癌患者就医延迟影响因素差异具有统计学意义(P<0.05);经Logistic回归模型分析结果显示:年龄>60岁、付费方式(新型农村合作医疗)非影响肝细胞癌患者就医延迟的危险因素(P>0.05);居住在农村及乡镇、人均月收入<1500元、不知晓慢性病毒性肝炎随访检查情况是影响肝细胞癌患者就医延迟的独立危险因素(P<0.001)。结论肝细胞癌患者就医延迟率较高,在经济条件差的农村及乡镇较为普遍,以中老年患者居多,国家应加强对农村及乡镇医疗上的投入,医护人员应加大对中老年人慢性病毒性肝炎的筛查力度,降低患者的就医延迟率,改善肝细胞癌患者预后情况。Objective To investigate the incidence of medical delays and the influencing factors among patients with hepa-tocellular carcinoma. Methods The clinical data and follow - up data of 189 patients with hepatocellular carcinoma admitted to our hospital in 2016 were collected. Logistic regression analysis was used to investigate the factors that led to medical delays a- mong patients with hepatocellular carcinoma＊ Results A total of 49 cases （25. 93% ） experienced delayed medical treatment a- mong the 189 patients with hepatocellular carcinoma. Single factor analysis of medical delays among patients with hepatocellular carcinoma showed that no statistically significant difference was detected in the patients^ gender,marital status,educational levels, history of chronic viral hepatitis,or in family history of hepatocellular carcinoma （F〉0. 05）. However,significant difference was detected in such factors as age,residence,per capita monthly income,ways of payment,and the amount of knowledge of the results of the follow-up of chronic viral hepatitis （ P〈0. 05）. Logistic regression model analysis showed that age〉 60 years and payment methods （new rural cooperative medical care） were not risk factors for the delay in the treatment of patients with hepatocellular carcinoma （P〉0. 05） . Living in rural areas and towns, a per capita monthly income of less than 1500 RMB,and ignorance of fol-low-up of chronic viral hepatitis were independent risk factors for HCC patients with delayed medical treatment （P〈0. 001） . Conclusion The rate of medical delays in case of hepatocellular carcinoma is high, especially in deprived rural areas and amongmiddle-aged and elderly patients. Investment in rural areas and townships needs to be increased. Healthcare workers should en-large the range of screening of chronic viral hepatitis in middle-aged and elderly patients in order to reduce the delay rate of med-ical treatment and improve the prognosis of patients

关 键 词：肝细胞癌 就医延迟 影响因素 

分 类 号：R735.3[医药卫生—肿瘤]