不同转运模式对ST段抬高型急性心肌梗死直接PCI疗效的影响被引量：20

Influence of Different Transport Modes on the Efficacy of Direct Percutaneous Coronary Intervention in Acute ST-elevation Myocardial Infarction

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摘要目的:探讨不同转运模式对ST段抬高型急性心肌梗死(STEMI)患者直接经皮冠状动脉介入治疗(PCI)疗效的影响。方法:入选2013年1月—2014年12月行急诊PCI的268例STEMI患者,其中139例患者的一次性12导联心电图由社区医师或救护车上的急救人员通过手机微信传输到指定的心内科医师手机上(胸痛中心模式探索组),129例患者自行来院就诊(普通就诊组)。比较两组的进门到球囊扩张(D-to-B)时间和达标率(D-to-B低于90 min的概率),住院期间病死率、心力衰竭发生率,平均住院天数及住院费用。结果:胸痛中心模式探索组和普通就诊组的D-to-B时间[(86.4±4.5)min比(97.4±10.3)min,P<0.01]、住院期间病死率(2.9%比9.3%,P<0.05)、心力衰竭发生率(4.3%比11.6%,P<0.05)、平均住院天数[(8.7±3.2)d比(10.9±4.5)d,P<0.05]及住院费用[(50 347±19 310)元比(58 102±41 178)元,P<0.05]差异均有统计学意义。结论:区域胸痛中心模式能缩短STEMI患者的再灌注时间,降低近期病死率。 Objective：To explore the influence of different transport modes on the efficacy of direct percutaneous coronary intervention（PCI）in patients with acute ST-elevation myocardial infarction（STEMI）.Methods： A total of 268 STEMI patients undergoing emergency PCI during Jan 2013 and Dec 2014 were selected.Among them,there were 139 patients whose single-time 12-lead ECG results were scanned and sent to specified cardiologists＇ cellphones by ambulances or community doctors via wechat app（chest pain center mode exploration group）and 129 patients who went to hospital by themselves（common treatment group）.The door to balloon dilatation time（D-to-B）,the probability of D-to-B shorter than 90 minutes（target rate）,the mortality during hospitalization,the incidence of heart failure,the average hospitalization days and hospitalization cost were compared between the two groups.Results：The results of comparison between the chest pain center mode exploration group and the common treatment group were shown as below：the D-to-B time（[86.4±4.5]min vs.[97.4±10.3]min,P〈0.01）,hospital during mortality（2.9%vs9.3%,P〈0.05）,the incidence of heart failure（4.3% vs.11.6%,P〈0.05）,the average hospitalization days（[8.7±3.2]d vs.[10.9±4.5]d,P〈0.05]and hospitalization costs（[50 347±19 310]yuan vs.[58 102±41 178]yuan,P〈0.05）.And all the differences were statistically significant.Conclusions：Regional chest pain center mode can shorten the reperfusion time and reduce the short-term mortality for STEMI patients.

作者沈峻金惠根刘宗军欧少君杨伟汪志华李英梅郜俊清张文全汪蔚青

机构地区上海市普陀区中心医院心内科

出处《中国临床医学》 2016年第1期25-27,共3页 Chinese Journal of Clinical Medicine

基金上海市普陀区卫生系统自主创新科研资助项目(编号:2012PTKW005)

关键词心肌梗死急救医疗服务患者转送心肌再灌注 Myocardial infarction Emergency medical services Patient transport Myocardial reperfusion

分类号 R542.22 [医药卫生—心血管疾病]

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参考文献9

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