辽宁省农村地区急性心肌梗死患者院前就医延误及其影响因素分析  

Factors Associated with Patient Delay and Transfer Delay among Patients with Acute Myocardial Infarction in Rural Areas of Liaoning Province

作　　者：黄东辉[1,2] 张文良[3] 孙皓 时景璞[1] 

机构地区：[1]中国医科大学附属第一医院临床流行病学与循证医学教研室,沈阳110001 [2]中国医科大学附属盛京医院临床流行病学教研室,沈阳110004 [3]丹东出入境检验检疫局办公室,丹东118000

出　　处：《中国循证心血管医学杂志》2018年第1期63-67,共5页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的研究农村急性心肌梗死(AMI)患者院前就医延误情况,包括患者延迟(PD)和转移延迟(TD)情况的时间特点,并探讨其影响因素。方法研究对象为辽宁省15家县级医院的入院AMI患者,研究方法为统一问卷调查。统计学分析采用SPSS 20.0软件。多因素分析采用二分类Logistic回归模型。结果共纳入农村AMI患者822例。PD时间中位数为90 min,TD时间中位数为45 min。Logistic回归模型分析发现可能影响PD的独立影响因素包括高血脂史、糖尿病史、心肌梗死史、发病时间段、迟疑就医原因;可能影响TD的因素有医院级别、患者转移情况、交通方式和发病季节。结论农村AMI患者的院前就医延误时间中PD时间所占比例较大。PD和TD的影响因素反映出农村地区卫生资源的相对匮乏,居民对AMI的认识不足、就诊意识薄弱等现状。Objective This study aims to describe the patient delay （PD） and transfer delay （TD） in patients who suffering from acute myocardial infarction （AMI） in the rural areas of Liaoning province, and then to explore the associating factors in order to provide specific advice. Methods The subjects of this study were recruited from 15 county-level hospitals of Liaoning province. The eligible patients were enrolled and investigated by using uniform questionnaire. Statistical analysis was performed with SPSS20.0. The factors associated with PD and TD were explored by binary Logistic regression model. Results A total of 822 eligible patients were included in the study. The median PD time and TD time were 90 minutes and 45 minutes. The Logistic model had identified the history of hyperlipidemia, diabetes mellitus and myocardial infarction, circadian rhythm in AMI onset and causes of delay in seeking treatment as the associating factors with PD. The factors associated with TD included hospital level, patients’ transfer, transport mode and onset season. Conclusion Among the total prehospital delay time, the PD time had occupied a larger proportion than TD time. Interpretation of the findings reflects the necessity to spread the knowledge of AMI and improve patients’ accessibility to healthcare services in rural areas.

关 键 词：农村 急性心肌梗死 患者延迟 转移延迟 影响因素 

分 类 号：R542.22[医药卫生—心血管疾病]