检索历史 清除

目的 探讨社区健康教育对急性心肌梗死患者院外时间延误和住院转归的影响.方法 从2012年7月开始对山东省临沂市人民医院周边社区进行为期4个月的健康教育,指导患者胸痛后及时到医院就诊.健康教育后1年内(2012年11月1日至201 3年10月31日)收治的社区内ST段抬高型急性心肌梗死患者为观察组,共89例;健康教育前1年内(2011年7月1日至2012年6月30日)收治同一社区内ST段抬高型急性心肌梗死患者为对照组,共81例.记录两组患者的院前延误时间、溶栓与急诊介入治疗例数、住院期间严重并发症发生率、死亡率.计数资料比较采用x2检验或Fisher确切概率检验;计量资料正态分布数据比较采用t检验,偏态分布数据比较采用Wilcoxon秩和检验.结果 观察组患者院外延误时间中位数为80 (47～ 150)min,短于对照组的90(60 ～255) min(WilcoxonW值=6 912.00,Z值=-2.182,P=0.029);观察组患者再灌注治疗比例为54％(48/89),高于对照组的38％ (31/81)(x2=4.181,P=0.041);观察组患者住院期间总的恶性并发症发生率为24％(21/89),低于对照组的42％(34/81),差异有统计学意义(x2=6.732,P=0.009).结论 社区健康教育可有效缩短急性心肌梗死患者的院外时间延误,增加再灌注治疗的比率和减少总的恶性并发症发生率.

Objective To evaluate the effect of community health education on pre-hospital delay and clinical outcomes of hospitalization of the patients with acute myocardial infarction.Methods Community health education for the adults living near the Linyi People's Hospital was conducted from July 1st to October 30th,2012.ST-elevation acute myocardial infarction identified 1 year prior to or during the health education program was used as control (n=81) or study group (n=89),respectively.Delay from the onset of ST-elevation acute myocardial infarction symptoms to hospital admission,the rate of reperfusion therapy,the in-hospital malignant complications and the death rate were compared between the two groups.Student's t test,Chi-square test,Fisher's exact probability test and the Wilcoxon rank sum test were used for data analysis.Results Median pre-hospital delay was 80 (47-150) min in the study group,less than 90 (60-255) min of the control group (Wilcoxon W=6 912.00,Z=-2.182,P=0.029).The rate of reperfusion therapy was 54％ in the study group,higher than 38％ of the control group (x2 =4.181,P=0.041).The overall incidence of severe complications during hospitalization was 24％ in the study group,less than 42％ in the control group (x2=6.732,P=0.009).Conclusion Community health education could decrease pre-hospital delay for acute myocardial infarction,improve the rate of reperfusion therapy and decrease the overall incidence of severe complications during hospitalization.