恩施地区痛风患者就医行为及依从性调查

目的 探讨痛风（gout）患者就医行为和依从性的现状.方法 对确诊痛风患者467例进行现场及网上调查,回收有效问卷调查量表447份.包括患者的一般情况（性别、年龄、红肉摄入量、文化水平、年收入情况）、就医行为（首诊科室、确诊科室、确诊时间及疾病认知情况）、诊疗及转归情况（治疗用药状况、随诊频率与血尿酸达标相关性、伴随疾病情况）.结果 痛风发病率与饮食结构、文化水平、年收入分布等因素存在相关性.患者就诊首选科室依次为骨关节科（34.00％）,疼痛科（16.33％）、中医科（14.76％）、风湿免疫科（13.87％）、内分泌科（9.84％）、肾内科（7.15％）、普外科（4.02％）,其中风湿免疫科首次确诊率最高,确诊率达93.54％ （58/62）.大部分患者对痛风相关知识缺乏了解,仅22.81％的患者比较全面了解痛风的相关知识.在治疗过程中,有相当数量的患者26.84％（120/447）从不随访.结论 显示本地区痛风人群构成和人群受教育程度及年收入等情况存在相关性,另外,治疗现状不容乐观,主要表现为误诊、诊断延误,患者依从性欠佳,血尿酸达标率不满意.

The Investigation and Correlational Research of the Behavior of Seeking Medical Advice and Compliance in Patients with Gout in Enshi

Objective To study the current care-seeking behaviors and compliance of patients with gout.Methods 467 cases of patients with gout were investigated on-site and online.447 questionnaire survey scales were recycled.The questionnaires included patients＇ general information （ gender, age, diet structure, annual income and education level, etc.） and care-seeking behaviors （department for the initial diagnosis,department of definite diagnosis,confirmed time and understanding on health education）.Results There is a correlation between the incidence of gout with diet structure,cultural level and distribution of annual income, etc.The preferred departments of the patients in turn are the bone and joint department （34.00%）, pain management （16.33%）, TCM department （14.76%）, department of rheumatism and immunology （ 13.87%）, endocrinology department （9.84%）, renal medicine （7. 15%） and general surgery （4.02%） ,where department of rheumatism and immunology has the highest rate of definite diagnosis at the first time, with the diagnosis rate of 93.54% （58/62）. The majority of patients lack the understanding on gout-related knowledge, only 22.81% of the patients have relatively thorough knowledge about gout. 26.84% （120/447） of people never follow up during the treatment.Conclusion This data shows that there is relationship between the gout population composition with the education level and annual income of the patients in this region. In addition, the current treatment situation of gout in this region is not optimistic, which mainly shows misdiagnosis, delayed diagnosis, poor compliance and unsatisfactorily achieved rate of blood uric acid.