胃食管反流病患者就医延迟现状及其影响因素研究  

Delay in seeking medical care among patients with gastroesophageal reflux disease:Current status and influencing factors

作　　者：许建龙 王双燕[1] 庄李磊[1] 黄敏芳 Jian-Long Xu;Shuang-Yan Wang;Li-Lei Zhuang;Min-Fang Huang(Endoscopy Center,Yiwu Central Hospital,Yiwu 322000,Zhejiang Province,China)

机构地区：[1]义乌市中心医院内镜中心,浙江省义乌市322000

出　　处：《世界华人消化杂志》2025年第1期45-52,共8页World Chinese Journal of Digestology

基　　金：义乌市科研计划项目,No.20-3-034.

摘　　要：背景胃食管反流病(gastroesophageal reflux disease,GERD)患病率近几年呈持续上升状态,反流物对食管黏膜长期不断地刺激,易造成粘膜损伤处修复功能紊乱.目前鲜见对胃食管反流患者关于就诊时间的相关研究.目的探讨GERD患者就医延迟发生情况及其影响因素.方法采用便利抽样法,选取2024-05/2024-09在浙江省某三级甲等医院初次确诊为GERD患者300例,使用一般资料调查表、疾病就医情况问卷、社会支持量表进行调查,了解其就医延迟发生情况,并采用多因素二元Logistic回归分析其影响因素.结果胃食管反流病患者出现就医延迟的中位时间为15 d,就医延迟发生率为54%.单因素分析显示,年龄段、居住地、文化程度、疾病认知水平、是否合并慢性病、有无胃镜检查史、社会支持水平7个因素对GERD患者就医延迟情况有影响(P<0.05).单因素Logistic回归分析结果显示,年龄段、居住地、文化水平、疾病认知水平、是否合并慢病、胃镜检查史和社会支持水平在单因素回归分析中有统计学意义(P<0.05).多因素二元Logistic回归分析显示,文化程度、社会支持水平、疾病认知水平、胃镜检查史、是否合并慢性病是GERD患者出现就医延迟情况的独立影响因素(P<0.05).结论GERD患者就医延迟的现象较普遍.多发生在文化程度低,社会支持水平低,疾病认知不足,无胃镜检查史和合并慢性病的患者中,应引起医护人员以及社区工作人员的注意,加强GERD知识的宣传以及干预,增强患者及早就医意识.BACKGROUND In recent years,the prevalence of gastroesophageal reflux disease(GERD)has been on a continuous rise,with the refluxate causing constant irritation to the esophageal mucosa.As a result,disordered mucosal repair functions are caused.Currently,there is a scarcity of studies regarding the consultation time of patients with GERD.AIM To investigate the occurrence of delay in seeking medical care among patients with GERD and its influencing factors.METHODS A convenience sampling method was used to select 300 patients diagnosed with GERD for the first time from May 2024 to September 2024 at a tertiary hospital in Zhejiang Province.A general information survey form,a disease medical situation questionnaire,and a social support scale were used to investigate the occurrence of delay in seeking medical care,and binary logistic regression analysis was used to identify the influencing factors.RESULTS The median time for delay in seeking medical care in GERD patients was 15 days,with a prevalence of 54%.Univariate analysis showed that age group,place of residence,educa-tional level,disease awareness,presence of chronic diseases,history of gastroscopy,and social support level were factors affecting delay in seeking medical care in GERD patients(P<0.05).Binary logistic regression analysis showed that educational level,social support level,disease awareness,history of gastroscopy,and presence of chronic diseases were independent influencing factors for delay in seeking medical care in GERD patients(P<0.05).CONCLUSION The phenomenon of delay in seeking medical care among GERD patients is relatively common,mainly occurring in patients with low educational level,low social support level,insufficient disease awareness,no history of gastroscopy,and chronic diseases.This should attract the attention of medical staff and community workers to strengthen the promotion of GERD knowledge and intervention,and enhance patients’awareness of seeking medical treatment as early as possible.

关 键 词：胃食管反流病 食管炎 就医延迟 胃镜 现况调查 

分 类 号：R57[医药卫生—消化系统]