摘要
背景心血管疾病是严重威胁广大人民群众健康的疾病,每年全世界约有1 670万人死于心血管疾病。在我国,冠状动脉粥样硬化性心脏病(CAHD)也是威胁人民群众健康的首要心血管疾病,每年约有70万人死于CAHD。CAHD的治疗方法中,针对ST段抬高型心肌梗死(STEMI)的治疗手段主要是直接经皮冠状动脉介入治疗(PCI)。目的分析优化绿色通道对STEMI患者直接PCI延迟时间及预后的影响,为临床工作者对STEMI急诊救治工作提供理论依据。方法选取2013—2014年于郑州人民医院通过优化后绿色通道行直接PCI的符合纳入标准的STEMI患者117例为试验组。回顾性选取2011—2012年于郑州人民医院通过优化前绿色通道行直接PCI的符合纳入标准的STEMI患者107例为对照组。记录患者一般资料、延迟时间〔患者出现症状到报警时间、120接警时间、指派急救站时间、接受任务到出诊时间、出诊到抵达现场时间、现场到首次医疗接触时间、首次医疗接触到首份心电图时间、首次医疗接触到口服双抗药物(阿司匹林肠溶片300 mg、氯吡格雷600 mg)时间、急诊医师初步告知病情到患者理解时间、院前远程会诊及导管室预激活时间、待诊专科医师二次告知并签字时间、入导管室到球囊扩张时间、进门到球囊扩张时间(D2B)〕、预后因素〔TIMI心肌灌注分级(TMP)、30 d病死率、PCI后严重不良心血管事件(心力衰竭、心律失常、心源性休克、复流后再梗死)发生率〕。结果试验组患者出现症状到报警时间、120接警时间、指派急救站时间、首次医疗接触到首份心电图时间、首次医疗接触到口服双抗药物时间、待诊专科医师二次告知并签字时间、D2B短于对照组,急诊医师初步告知病情到患者理解时间、院前远程会诊及导管室预激活时间长于对照组(P<0.05);两组接受任务到出诊时间、出诊到抵达现场时间、现场到首�
Background Cardiovascular disease threatens the health of people severely. About 16. 7 million of people annually die from cardiovascular disease all around the world. In China,coronary atherosclerotic heart disease（ CAHD） is also a major threat to the health of people,and about 700 thousand people die from CAHD each year. Of the treatment patterns for CAHD, primary percutaneous coronary intervention（ PCI） is the main treatment for ST- elevation myocardial infarction（ STEMI）. Objective To analyze the effect of application of optimized green channel on how long the primary PCI for STEMI patients is delayed and on their prognosis,so as to provide a theoretical basis for clinical emergency treatment of STEMI. Methods117 STEMI patients who underwent primary PCI through optimized green channel in People＇s Hospital of Zhengzhou from 2013 to 2014 and met the inclusion criteria were selected as trial group. And 107 STEMI patients who performed primary PCI through non- optimized green channel in People＇s Hospital of Zhengzhou from 2011 to 2012 and met the inclusion criteria were selected as control group. The general data of the patients,delay time 〔time from the symptom onset in STEMI to calling the 120 medical emergency command center,time of the worker of 120 medical emergency command center answering the emergency call,time of first- aid station was assigned,time from accepting the task to starting to pay home visits,time from starting to pay home visits to arrival,time from arrival to the first medical contact,time from first medical contact to performing the first ECG,time between first medical contact and the patient orally prescribed two kinds of anticoagulant drugs（ aspirin enteric- coated tablets 300 mg and clopidogrel 600 mg）, duration between the patient was informed his conditions by the emergency physician initially and he understood it,time of pre- hospital remote consultation and pre- activation time of cardiac catheterization lab,duration between the patient or his relatives were inf
出处
《中国全科医学》
CAS
CSCD
北大核心
2016年第36期4499-4503,共5页
Chinese General Practice
关键词
心肌梗死
血管成形术
气囊
冠状动脉
急救
绿色通道
延迟
预后
Myocardial infarction
Angioplasty
ballon
coronary
First aid
Green channel
Delay
Prognosis
