急性主动脉夹层患者首发症状与院前延迟的关系研究

目的探讨急性主动脉夹层患者首发症状与院前延迟的关系,为临床实施院前针对性健康教育提供参考。方法选取急性主动脉夹层患者488例,收集患者首发症状、一般资料、疾病相关因素、院前相关因素及院前时间,分析首发症状与院前延迟的关系。结果患者院前时间为135.5(48.3, 1 735.5) min,其中院前时间≤150 min 253例(51.8%),>150 min(即院前延迟)235例(48.2%);首发症状多为胸背痛146例(29.9%)],其次为胸前痛124例(25.4%)、腹痛121例(24.8%)。Logistic回归分析发现自觉病情严重程度、胸背痛是院前延迟的保护因素(P<0.01),腹痛、四肢麻木/疼痛是急性主动脉夹层患者院前延迟的危险因素(P<0.05,P<0.01)。结论急性主动脉夹层患者常以胸背痛为首发症状,腹痛与四肢麻木/疼痛非典型症状是导致急性主动脉夹层患者出现院前延迟的主要因素。需对公众加强疾病相关知识的健康教育,早期采取正确的应对方式,积极就医,缩短院前时间。

Relationship between the initial symptoms and prehospital delay among patients with acute aortic dissection

Objective To explore the relationship between the initial symptoms and prehospital delay among patients with acute aortic dissection,and to provide reference for conducting targeted prehospital health education.Methods A total of 488 patients with acute aortic dissection were selected,and their initial symptoms,general information,disease-related factors,prehospital related factors and prehospital time were collected to analyze the relationship between the initial symptoms and prehospital delay.Results The prehospital time of the participants was 135.5(48.3,1735.5)min,the time of 253 patients(51.8%)was less or equal to 150 min,and the other 235 cases(48.2%)was more than 150 min(prehospital delay).The most frequent initial symptom was chest and back pain,which was suffered from by 146 cases(29.9%),and it was followed by chest pain with 124 cases(25.4%)and abdominal pain with 121 cases(24.8%).Logistic regression analysis showed that,self-perceived severity of the condition,chest and back pain were protective factors,while abdominal pain and limb numbness/pain were risk factors of prehospital delay in patients with acute aortic dissection(P<0.05,P<0.01).Conclusion Chest and back pain is the initial symptom in patients with acute aortic dissection,and their atypical symptoms of abdominal pain and limbs numbness/pain are the major factors resulting in prehospital delay.Therefore,it is necessary to strengthen disease related health education for the public,so as to help them adopt correct coping strategies in the early stage,seek medical treatment actively,and shorten the prehospital time ultimately.