急性心肌梗死就诊延迟相关因素调查研究

Investigation on related factors of delayed treatment in patients with acute myocardial infarction

目的初步调查分析急性心肌梗死患者院前及院内就诊延迟的主要相关因素。方法收集宁夏固原市第二人民医院急诊科及心内科住院的AMI患者218例,调查统计患者一般资料、人文因素、社会因素方面的20余项具体因素,从而分析出可能影响患者及时就诊的相关因素。结果 218例AMI患者中,及时就诊47例(21.6%),就诊延迟171例(78.4%);院前就诊延迟可能相关因素有:患者教育程度、疾病认知程度、经济收入、既往心脏病病史、胸痛程度、就诊距离、交通工具的选择及是否呼救急救系统,差异均有统计学意义(P<0.05);院内诊治延迟的可能环节有候诊时间、等待检查、医嘱-给药时间。结论 AMI患者就诊延迟现象严重,应进一步提高患者及时就诊的意识和完善医院相关管理制度。

Objective To investigation and analysis the related factors of delayed treatmen （pre-hospital and in-hospital） in pa-tients with acute myocardial infarction （AMI） .Methods 218 patients with AMI from inpatient department of cardiology and emer-gency ,and to analyze the factors that may affect patients medical timely through investigated and analyzed more than 20 specific fac-tors ,including general information ,human and social factors ,etc .Results In 218 case of AMI ,47 cases of timely treatment （21 .6% ） ,171 cases of delaying treatment （78 .4% ） in 218 patients with AMI .The results showed that education level ,disease awareness level ,economic income ,previous history of heart disease ,chest pain level ,treatment distance ,transport choices and whether call a first-aid or not had significant differences between timely treatment group and delaying treatment group （P〈0 .05） . Hospital diagnosis and treatment delay may link with waiting time ,waiting for examination ,the doctor′s advice-delivery time .Con-clusion Patients with AMI treatment delay is serious ,the awareness of patients timely treatment and hospital management system should be further improved .