影响烟雾病患者早诊疗的相关因素调查分析

Analysis of the Factors Influencing Moyamoya Patients' Medical Treatment Seeking

目的了解烟雾病患者的诊疗过程,促进患者早诊断、早治疗,减少误诊率。方法采用病历回顾法调查405例烟雾病患者的临床特点和诊疗过程的相关情况。结果本组患者以缺血型为主,占82.5%,主要症状多见为运动障碍、头痛和语言障碍;患者首诊的医院以市、县级医院为主,首诊科室主要是神经内科(77.8%)。首诊中位时间0.033个月,确诊中位时间6.000个月,转诊至本院的中位时间13.000个月。儿童与成人患者就诊时间差异有统计学意义(P<0.05),确诊时间差异无统计学意义(P>0.05);不同居住地患者,就诊时间差异无统计学意义(P>0.05),确诊时间有统计学意义(P<0.05)。患者及患儿家长对烟雾病知识普遍认识不足。结论烟雾病患者的诊疗时间过长,年龄和医疗条件是影响患者及早就诊的重要因素。应加强患者相关知识教育,同时也要提高医护人员的对本病的认识,促进患者早诊断、早治疗,减少误诊率。

Objective To understand Moyamoya patients＇ medical treatment seeking, so as to encourage timely diagnosis and treatment and lower the rate of misdiagnoses and mistreatments. Methods A retrospective analysis was made of the clinical features and the processes of medical seeking by 405 cases with Moyamoya. Results The patients in this study were predominantly ischemic, accounting for 82.5%, with their major symptoms being motion disorder, headache and verbal disorder. The hospitals they visited for the first time were mainly county-level or prefecture-level ones, and the departments, neurology, departments accounting for 77.8%. The median of the first-time medical seeking and conclusive diagnoses were 0.033 months and 6.000 months, respectively. The difference in the medical seeking time between children and adults was statistically significant （P〈0.05）, while that in the conclusive diagnoses, not （P〉0.05）. The difference in the medical seeking time between patients of different residential places was not statistically significant （P〉0.05）, while that in the conclusive diagnoses, was （P〈0.05）. Insufficient understanding of the disease was prevalent among the patients and their dependents. Conclusion The long time needed for the diagnosis and treatment of Moyamoya, age and medical facilities are important factors affecting such patients＇ timely medical treatment seeking. Education in related knowledge should be beefed up, and the medical staff＇s-knowledge of the disease should also be enhanced.