急性ST段抬高型心肌梗死患者院前延迟影响因素的调查研究
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摘要
目的探讨急性ST段抬高型心肌梗死患者院前延迟的影响因素。方法采用自行设计的资料调查表对2017年5月-2018年10月就诊于我院的142例急性ST段抬高型心肌梗死患者进行调查。研究者为经过培训的心内科护士,收集内容包括年龄、性别、经济来源、文化程度、发病时有无陪伴人员、患者对疾病是否认知、陪伴人员对疾病是否认知、糖尿病史、就医决策人性别、疼痛程度评分、发病症状是否典型等为影响因素,同时收集患者院前延迟时间作为本研究的结局变量。结果高龄、女性、无经济来源、对疾病缺乏认知、疼痛症状不典型以及疼痛程度较轻是患者院前延迟的影响因素。结论加强对高龄女性、无经济来源、对疾病缺乏认知、发病症状不典型以及疼痛程度较轻患者的急性心肌梗死认知宣教,强化急救意识,提高和改善基层医院医疗水平,是缩短急性心肌梗死患者院前延迟时间的关键。
Objective To study the factors influencing prehospital delay in patients with acute st segment elevation myocardial infarction.Methods 94 patients with acute st segment elevation myocardial infarction admitted to our hospital from May 2017 to December 2017 were investigated by self-designed questionnaire.The investigators were trained cardiologic nurses.The data collected included age,sex,economic source,education level,accompanying staff at onset,patients' awareness of disease,accompanying staff's awareness of disease,history of diabetes mellitus,sex of medical decision-makers,pain score,typical symptoms and other influencing factors.At the same time,patients' pre-hospital delay time was collected.As the outcome variable of this study.Results The influencing factors of pre-hospital delay was age,female,no financial source,lack of awareness of disease,diabetes mellitus,atypical pain symptoms and mild pain.Conclusion Strengthen the awareness and education on acute myocardial infarction in elderly women,patients without financial resources,lack of awareness of disease,patients with diabetes mellitus,atypical symptoms and mild pain,and Strengthen the awareness of first aid and improving the medical level of primary hospitals are the key to shorten the pre-hospital delay time of acute myocardial infarction.
Objective To study the factors influencing prehospital delay in patients with acute st segment elevation myocardial infarction.Methods 94 patients with acute st segment elevation myocardial infarction admitted to our hospital from May 2017 to December 2017 were investigated by self-designed questionnaire.The investigators were trained cardiologic nurses.The data collected included age,sex,economic source,education level,accompanying staff at onset,patients' awareness of disease,accompanying staff's awareness of disease,history of diabetes mellitus,sex of medical decision-makers,pain score,typical symptoms and other influencing factors.At the same time,patients' pre-hospital delay time was collected.As the outcome variable of this study.Results The influencing factors of pre-hospital delay was age,female,no financial source,lack of awareness of disease,diabetes mellitus,atypical pain symptoms and mild pain.Conclusion Strengthen the awareness and education on acute myocardial infarction in elderly women,patients without financial resources,lack of awareness of disease,patients with diabetes mellitus,atypical symptoms and mild pain,and Strengthen the awareness of first aid and improving the medical level of primary hospitals are the key to shorten the pre-hospital delay time of acute myocardial infarction.
引文
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[15]张啸飞,胡大一,丁荣晶,等.中国心脑血管疾病死亡现况及流行趋势[J].中华心血管病杂志,2012,40(3):179-187.
[16] Mackay M H,Ratner P A,Nguyen M,et al.Inconsistent measurement of acute coronary syndrome patients’prehospital delay in research:A review of the literature[J].Eur J Cardiovasc Nurs,2014,13(6):483-493.
[17] Marcin S,Mariusz G,Marek G,et al.Clinical characteristics of polish women with ST segment elevation myocardial infarction[J].Kardiologia Polska,2010,68(6):627-634.
[2] Elmenyar A,Zubaidm,Shehab A,et al.Prevalence and impact of cardiovascular risk factors among patients presenting with acute coronary syndrome in the middle east[J].Clin Cardiol,2011,34(1):51-58.
[3] Palmieri L,Veronesi G,Corrao G,et al.Cardiovascular diseases monitoring:lessons from population-based registries to address future opportunities and challenges in Europe[J].Arch Public Health,2018,76(6):31.
[4] Song P S,Ryu D R,Kim M J,et al.Risk scoring system to assess outcomes in patients treated with contemporary guidelineadherent optimal therapies after acute myocardial infarction[J].Korean Circ J,2018,48(6):492-504.
[5]张念.急诊PCI治疗急性心肌梗死的临床观察与护理[J].护士进修杂志,2008,23(18):1695-1696.
[6]陈剑峰.急性ST段抬高型心肌梗死再灌注治疗院前及院内延误的相关研究[D].郑州大学,2017.
[7]张妮,张金霞,肖华,等.首次医疗接触后院前延误对急性ST段抬高型心肌梗死患者进门至球囊扩张时间的影响研究[J].中国实用内科杂志,2016,36(9):800-801.
[8] Herlitz J,Thuresson M,Svensson L,et al.Factors of importance for patients’decision time in acute coronary syndrome[J].Int J Cardiol,2010,141(3):236-242.
[9]刘云军,梁岩,朱俊.急性心肌梗死院前延迟诊治因素的分析[J].河北医药,2010,32(8):975-976.
[10]谢拉,商薇薇.AMI患者院前决定延误的影响因素分析[J].世界最新医学信息文摘,2017,17(33):21-22.
[11]陈剑峰,薛书峰,张守彦,等.高龄急性心肌梗死患者院前延误时间的相关研究[J].重庆医学,2017,46(1):72-77.
[12] Ezire O,Adebayo S B,Idogho O,et al.Determinants of use of insecticide-treated nets among pregnant women in Nigeria[J].Int J Womens Health,2015,26(7):655-61.
[13] Birkemeyer R,Schneider H,Rillig A,et al.Do gender differences in primary PCI mortality represent a different adherence to guideline recommended therapy a multicenter observation[J].BMC Cardiovasc Disord,2014(14):71.
[14]王凯.突发事件下决策者的框架效应研究[D].杭州:浙江大学,2010.
[15]张啸飞,胡大一,丁荣晶,等.中国心脑血管疾病死亡现况及流行趋势[J].中华心血管病杂志,2012,40(3):179-187.
[16] Mackay M H,Ratner P A,Nguyen M,et al.Inconsistent measurement of acute coronary syndrome patients’prehospital delay in research:A review of the literature[J].Eur J Cardiovasc Nurs,2014,13(6):483-493.
[17] Marcin S,Mariusz G,Marek G,et al.Clinical characteristics of polish women with ST segment elevation myocardial infarction[J].Kardiologia Polska,2010,68(6):627-634.