摘要
目的调查急性ST段抬高型心肌梗死(STEMI)患者症状发作-到达医院及开始治疗的时间,分析导致院前和院内延迟相关因素。方法前瞻性调查连续住院的329例STEMI患者,分析社会描述性变量、临床、心理因素等对院前延迟的影响。将门-住院时间分成≤60min和>60min两组,分析延迟因素。并做心肌梗死知识及来源调查。结果多元logistic回归分析表明:危险因素>3个、发病时担心打扰别人与院前延迟长有关,而症状进展、重视反应和直接到定点医院则与院前延迟短有关。影响患者门-住院的因素是急救车转运、急诊就医和就诊1次。结论患者发病后到院及院内延迟明显,需加强对公众的健康教育,提高患者症状发作后的求医意识,提倡急救车转运,缩短签字同意时间,同时强调减少院内环节,缩短院内延迟。
Objective To investigate the delay in time from symptoms onset to arrival at the hospital and time to treatment and to evaluate the factors associated with the delay in patients with acute ST elevation myocardial infarction （STEMI）. Methods In this prospective study, 329 consecutive patients with confirmed STEMI admitted to hospital were studied between September, 2006 and July, 2009. The factors influencing prehospital delay were explored. Door to admission time was also divided into two groups： less than 60 minutes group and more than 60 minutes group. The data recorded included patients＇ knowl- edge of acute myocardial infarction. Results Logistic regression analysis showed that significant risk factors related to prehospital delay included more than 3 risk factors, worried about troubling others, progressive symptoms, took the symptoms seriously, directly went to study hospitals, the factors associated with door to admission less than 60 minutes were ambulance transportation, going to emergency and diagnosis once. Conclusion Most of the delay was caused by the patients themselves, a factor which needs to be improved by better education. Advising patients to call directly an ambulance, Moreover, optimizing in -hospital processes should further shorten the delay to reperfusion therapy.
出处
《实用心脑肺血管病杂志》
2010年第3期304-306,共3页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
心肌梗死
延迟
影响因素
Myocardial infarction
Delay
Influencing factors
