急性心肌梗死患者院前延误状况及原因分析

Factors related to pre-hospital delay times in patients with acute myocardial infarction

目的:了解急性心肌梗死(AMI)患者院前延误状况并分析影响因素,以便采取有效干预措施,减少院前延误时间,提高救治率。方法:使用自行设计的调查问卷对某三级甲等医院心内监护室(CCU)收治的69例急性心肌梗死患者的院前延误时间及相关影响因素进行调查与分析。结果:患者院前延误中位时间为4h,在发病1h、2h、6h内就医者分别为5.8%、18.8%、76.8%;就诊时间>6h者为23.2%。多元Logistic回归分析显示:症状归因、首诊医院情况、症状出现后患者的处理方式、患者感知疾病的严重性与院前延误时间显著相关。结论:医务人员应做好患者健康教育,加强患者及家属对AMI相关知识的学习,缩短院前延误时间,提高救治率。

Objective： To explore potential predictors of patient delay time from onset of symptoms to time medical assistance was sought in a consecutive sample of patients admitted to CCU with acute myocardial infarction （AMI）. Method： Pre-hospital delay data were collected from 69 patients with AMI using patient＇s medical notes and semi-structured interviews. Result：The median pre-hospital delay time of patients was 4 h. The proportions of pa-tients went to the hospital within 1 hour,2 hours,6 hours after the onset of symptoms were 5.8% ,18.8% and 76. 8 % respectively. In multiple logistic regression analysis, attribution of symptoms to heart disease and choosing to call their general practitioner for an initial evaluation had a significant predictive effect on pre-hospital delay. In ad-dition, pre-hospital delay was associated with the perspective of patients＇s perceived severity and their perceived abil-ity to cope with symptoms. Conclusion： There is still a need for public awareness of the appropriate responses to AMI symptoms. Interventions should take into account the variety of cognitive and behavioral factors involved in decision making.