摘要
目的了解和分析上海市嘉定区胃癌患者在选择就医至确诊为胃癌的影响因素。方法收集2013年1月至2018年4月上海交通大学附属瑞金医院北院接受外科胃癌根治术患者共589例的临床资料。调查患者的主诉、学历、有无医保、常住地址、发病年龄、就医后选择是否为胃镜检查方式对患者确诊为胃癌的影响。并采用χ2检验、多因素Logistic回归模型等方法进行统计学分析。结果 589例患者及时就诊的影响因素包括患者是否存在报警症状(即主诉)及常住地址(与就诊医院的距离)(P <0. 05)。患者来院就诊后选择下一步接受胃镜检查,或是坚持服药缓解症状,则与患者主诉、是否有医保、常住地址、发现症状及时就医与否有关(P <0. 05)。患者首次就医至确诊时间的长短,与患者的主诉、常住地址、就医后是否选择胃镜检查方式相关(P <0. 05)。Logistic回归分析显示,主诉(OR=1. 550,95%CI:1. 346～1. 784)、有无医保(OR=1. 942,95%CI:1. 023～3. 686)是胃癌确诊及时性的危险因素。而发病年龄(OR=0. 970,95%CI:0. 947～0. 994)、常住地址(OR=1. 699,95%CI:1. 519～1. 943)、就医后选择方式(OR=1. 010,95%CI:1. 052～1. 128)是胃癌确诊及时性的保护因素。结论患者出现症状、就诊、确诊为胃癌的及时性,与患者有无医保、不适主诉、常住地址等密切相关。
Objective To analyze the influencing factors of gastric cancer patients in Jiading district of Shanghai who were chosen to seek medical treatment and diagnosed as gastric cancer.Methods Clinical data of a total of 589 gastric cancer were obtained from patients undergoing surgical radical gastrectomy in Ruijin Hospital North,Shanghai Jiao Tong University School of Medicine.The patients’main complaint,education,medical insurance or not,permanent address,age of onset,and whether or not to choose a gastroscopy to confirm the diagnosis of gastric cancer were investigated.χ2 test and Logistic regression model were used to make statistical analysis.Results The influencing factors of 589 patients’timely visits included whether the patient had an alarm symptom and the permanent address(P<0.05).After the patient come to the hospital for treatment,he or she chose to take the gastroscopy or not depended on the patients’complains,medical insurance,permanent address,whether to visit a doctor in time when the symptoms were discoveried(P<0.05).The length time of the patient to diagnosis was related to the patient’s complaint,permanent address,whether to choose a gastroscopy after medical treatment(P<0.05).Logistic regression analysis showed that the main risk factors for the timely diagnosis of gastric cancer were the main complaint(OR=1.550,95%CI:1.346-1.784)and with or without medical insurance(OR=1.942,95%CI:1.023-3.686).The age of onset(OR=0.970,95%CI:0.947-0.994),resident address(OR=1.699,95%CI:1.519-1.943)and the choice of medical treatment(OR=1.010,95%CI:1.052-1.128)were the protective factors for the timely diagnosis of gastric cancer.Conclusion The patients’symptoms,treatment,and timeliness of diagnosis of gastric cancer are closely related to whether the patient has medical insurance,discomfort,and permanent address.
作者
谢玲
尚莹莹
吴云林
陈平
李芹芹
叶知秋
罗方秀
项明
蔡波尔
朱时燕
周郁芬
丁燕飞
XIE Ling;SHANG Yingying;WU Yunlin;CHEN Ping;LI Qinqin;YE Zhiqiu;LUO Fangxiu;XIANG Ming;CAI Boer;ZHU Shiyan;ZHOU Yufen;DING Yanfei(Department of Gastroenterology,Ruijin Hospital North,Shanghai Jiao Tong University School of Medicine,Shanghai 201801;Department of Internal Medicine,Jiading Hospital of TCM in Shanghai,China)
出处
《胃肠病学和肝病学杂志》
CAS
2019年第1期24-28,共5页
Chinese Journal of Gastroenterology and Hepatology
关键词
胃癌
上海嘉定
诊断
Gastric cancer
Jiading district of Shanghai
Diagnosis
