胃癌患者诊断延迟及其原因的调查分析

Diagnostic delay on 232 patients with gastric cancer

目的：了解胃癌患者诊断延迟的流行病学现状，分析诊断延迟的高危因素。方法：收集衢州市人民医院2002年1月至2006年12月问收治的胃癌患者232例。分析其诊断延迟及影响因素。结果：胃癌患者的平均诊断延迟时间是3．6月（o．5月～36月），其中短期延迟119例，中期延迟57例，长期延迟56例。单因素分析显示，年龄（P=0．028）、居住地（P=0．000）、文化程度（P=0．026）、症状多少（P=0．000）是影响胃癌患者诊断延迟的因素；多因素分析显示，65岁以上、小学及其以下文化程度、既往无就医史、多发症状患者发生长期延迟的危险性高（P〈0．05）。结论：低文化程度、老年、既往无就医史等三类人群胃癌的诊断延迟情况较严重，应当有针对性地加强胃癌早期诊断的宣教。

Objective To investigate the underlying factors contributing to the diagnostic delay on patients with gastric cancer. Methods A retrospective study was conducted on the 232 patients with gastric cancer which were treated from January 2002 to December 2006 in Quzhou Municipal People＇s Hospital. Diagnostic delay was classified into three groups： short delay （0-3 months）,intermediate delay （3-6 months） and long delay （〉6 months）. Results 232 patients had diagnostic delay from half a month to 36 months and the median diagnostic delay was 5.6 months. There were 119 patients in short delay group, 57 patients in intermediate delay and 56 in long delay. The monovariate analysis showed that the age （P：0. 028）, living area （P=0. 000）, education experience （P=0. 026）, number of symptoms （P = 0. 000） were the significant factors influencing the diagnostic delay of patients. The multivariate analysis showed that patients with age more than 65 years ,only received primary education or illiterate, no outpatients experience, multiple syndromes had an increased risk of long delay （P〈0. 05）. Conclusion The diagnostic delay of gastric cancer was very severe in low education population, elderly population, patients without outpatient experience. Health education must be strengthened to these patients with a purpose of improving early detection of gastric cancer.