摘要
目的：对急诊科急性心肌梗死（ＡＭＩ）急诊溶栓治疗适应证与中华心血管病杂志编委会拟定的ＡＭＩ溶栓疗法参考方案（溶栓疗法参考方案）适应证正确符合率进行比较，分析未接受溶栓治疗的原因，探讨扩大急诊溶栓治疗的适应证。方法：收集１９９５年２月～１９９７年２月急诊科收治的确诊ＡＭＩ患者资料，根据溶栓疗法参考方案，分析临床决策符合率。结果：共收集２００例符合ＡＭＩ诊断标准的患者的总溶栓率为２４．０％（４８／２００），溶栓正确符合率为１００．０％，非溶栓正确符合率为７７．０％。未接受溶栓的原因主要是因为患者来诊时间在发病后１２小时以上，年龄超过７０岁及非Ｑ波心肌梗死患者。结论：急诊科溶栓具有良好的正确符合率，但溶栓条件选择较严，使较多适宜溶栓治疗的患者未得到溶栓治疗。今后仍应加强对来诊时在发病后１２小时以内、年龄７０岁以上及非Ｑ波心肌梗死患者的溶栓研究。
Objective:To estimate concordance of clinical indications with consensus assessment for emergency thrombolysis in acute myocardial infarction (AMI),and to analyze the reasons for not using thrombolytic drugs.Methods:Over a period of 2 years (from Feb.1995 to Feb.1997),clinical data of patients admitted to our emergency department with diagnosis of AMI were collected and reviewed.Both thrombolysis and nonthrombolysis patients were eligible for inclusion.The concordance of emergency thrombolysis were compared with consensus.Results:The overall thrombolysis rate of 200 cases was 24 0% (48/200).The correct coincidence for patients with and without thrombolysis were 100 0% and 77 0%,respectively.The major reasons for nonthrombolytic therapy included:over 6￣12 hours after symptom onset,advanced age (>70 years) and nonQ wave infarction.Conclusions:This study demonstrates excellent agreement between clinical indications regarding thrombolysis and consensus.The criteria for emergency thrombolysis in AMI should be broadened,especially in those with delayed attendance more than 6￣12 hours after symptom onset,advanced age and nonQ wave infarction.
出处
《中国危重病急救医学》
CAS
CSCD
1999年第1期36-38,共3页
Chinese Critical Care Medicine
关键词
溶栓疗法
时间窗
心肌梗塞
治疗
适应症
acute myocardial infarction\ \ emergency thrombolysis therapy\ \ timewindow
