中外健康文摘
中外健康文摘
중외건강문적
WORLD HEALTH DIGEST
2014年
8期
83-84
,共2页
急性肺栓塞%就医%延迟
急性肺栓塞%就醫%延遲
급성폐전새%취의%연지
Acute pulmonary embolism%Seek treatment%Delay
目的：调查济宁地区急性肺栓塞患者决定就医延迟程度及影响因素。方法：入选2012年11月至2013年10月底就诊于济宁地区12家医院并与发病后24h内到院的169例急性肺栓塞患者。通过与患者进行结构式访谈及查阅病历，收集资料。以决定就医延迟30min为切点，分为早决定组及晚决定组，对比分析两组资料。结果：中位决定就医延迟为60min。多因素回归分析显示：肺栓塞病史、胸痛不明显、症状不典型、症状能够耐受、对该病的认识不够重视及未将症状归于急性肺栓塞是决定就医延迟＞30m i n的独立预测因素。早决定组患者具有更高的早期再灌注治疗率及更短的发病至再灌注治疗延迟。结论：济宁地区急性肺栓塞患者决定就医时间明显延迟，患者耐受情况、症状特点及认知因素影响决定就医延迟程度。
目的：調查濟寧地區急性肺栓塞患者決定就醫延遲程度及影響因素。方法：入選2012年11月至2013年10月底就診于濟寧地區12傢醫院併與髮病後24h內到院的169例急性肺栓塞患者。通過與患者進行結構式訪談及查閱病歷，收集資料。以決定就醫延遲30min為切點，分為早決定組及晚決定組，對比分析兩組資料。結果：中位決定就醫延遲為60min。多因素迴歸分析顯示：肺栓塞病史、胸痛不明顯、癥狀不典型、癥狀能夠耐受、對該病的認識不夠重視及未將癥狀歸于急性肺栓塞是決定就醫延遲＞30m i n的獨立預測因素。早決定組患者具有更高的早期再灌註治療率及更短的髮病至再灌註治療延遲。結論：濟寧地區急性肺栓塞患者決定就醫時間明顯延遲，患者耐受情況、癥狀特點及認知因素影響決定就醫延遲程度。
목적：조사제저지구급성폐전새환자결정취의연지정도급영향인소。방법：입선2012년11월지2013년10월저취진우제저지구12가의원병여발병후24h내도원적169례급성폐전새환자。통과여환자진행결구식방담급사열병력，수집자료。이결정취의연지30min위절점，분위조결정조급만결정조，대비분석량조자료。결과：중위결정취의연지위60min。다인소회귀분석현시：폐전새병사、흉통불명현、증상불전형、증상능구내수、대해병적인식불구중시급미장증상귀우급성폐전새시결정취의연지＞30m i n적독립예측인소。조결정조환자구유경고적조기재관주치료솔급경단적발병지재관주치료연지。결론：제저지구급성폐전새환자결정취의시간명현연지，환자내수정황、증상특점급인지인소영향결정취의연지정도。
Objective To investigate the factors associated with delay in decision to seek treatment in patients with acute pulmonary embolism(PE) in Shandong. Methods This prospective, cross-sectional,multicenter survey was conducted from November 1,2008 and December 31,2009. The participants consisted of 699 patients with acute pulmonary embolism within 24 h of symptom onset to 30 hospitals in Shandong. Data were col ected by semi-structured interviews and medical records review. The patients were categorized into an early decision group and the a late decision group based on the 30 min cut-off . Results The median(25%,75%) decision delay in PE patients was 60(20,180) min Factors associated with late decision in an univariate analysis were age≥65 years, retirement or unemployment , history of pulmonary embolism,symptom onset at home and intermittent symptoms, whereas presence of bystanders such as friends, coworkers or even strangers,unbearable symptoms, dyspnea,sweating, syncope and attribution of symptoms to cardiac origin were related to early decision. Multivariate logistic analysis showed that history of pulmonary embolism, absence of syncope,intermittent symptoms, bearable symptoms and attribution of symptoms to noncardiac origin were independent predictors of decision delay>30min. Patients in the early decision group had more chances to receive acute reperfusion therapies (P=0.001) and shorter time intervals from symptom onset to reperfusion therapies (P<0.001 ) . Conclusions To a great extent patients with PE in Shandong delayed in decision to seek treatment.History of acute pulmonary embolism,symptom characteristics and symptom attribution were associated with decision delay.
