摘要
目的探讨3种不同的临床急救途径对行皮冠状动脉介入(PCI)治疗的急性ST段抬高型心肌梗死(STEMI)患者抢救流程时间参数及预后影响分析。方法选取发病12h内进入邢台市人民医院接受PCI治疗的STEMI患者335例,其中传统通道组入院者84例、绿色通道组115例、优化绿色通道组136例。观察指标为第1次医疗接触至抗血小板治疗(FMC2A)时间、第1次医疗接触至球囊扩张(FMC2B)时间、就诊至球囊扩张(D2B)时间、第1次医疗接触至签署介入治疗同意书(FMC2S)时间、脑血管意外、住院期间第2次出现非致命心肌梗死、心源性与全因病死、发生心力衰竭,以及在调查时主要心血管事件的发生率。比较3组患者无事件生存率,分析影响STEMI患者在PCI手术后住院与半年随访期间临床预后的各种相关因素。结果传统通道组、绿色通道组及优化绿色通道组患者的FMC2A时间、FMC2B时间、FMC2S时间、D2B时间都依次缩短;3组住院期间发生心力衰竭、脑血管意外、再次出现非致命心肌梗死比较,差异无统计学意义(P>0.05);与传统通道组比较,绿色通道组和优化绿色通道组在住院期间包括心血管疾病在内的各种原因病死率均较低(P<0.05);与绿色通道组比较,优化绿色通道组在住院期间包括心血管疾病在内的各种原因病死率较低,但差异无统计学意义(P>0.05);随访期间3组患者的再次非致命性心肌梗死、心绞痛复发率、严重心律失常、靶血管再次的血管化发生率比较,差异无统计学意义(P>0.05);与传统通道组比较,绿色通道组和优化绿色通道组再次因心源性疾病入院、心力衰竭、心源性与全因病死率均较低(P<0.05)。结论优化绿色通道模型可显著减少FMC2A时间、FMC2B时间、FMC2S时间、D2B时间,并使PCI手术后住院与半年随访期间的临床预后得到改善。
Objective To compare the time and parameters of STEMI patients with PCI in STEMI patients with three different clinical emergency routes,such as traditional channel,green channel and optimized green channel.Methods A total of 335 patients with STEMI who underwent PCI treatment within 12 hours of onset were selected.Among them,84 cases were enrolled in the traditional channel group,115 were green passages and 136 were green channels.The main observation was the first（FMC2A）time,first medical contact to balloon dilatation（FMC2B）,treatment to balloon dilatation（D2B）time,first medical contact to sign of interventional treatment consent（FMC2S）time,cerebrovascular accident,the second time during hospital non-fatal myocardial infarction,cardiac and all-cause death,heart failure,and the incidence of major cardiovascular events in the survey,compared with three groups without event survival,the use of Logistic Regression analysis and analysis of STEMI patients in the PCI after surgery and half a year follow-up during the clinical prognosis of various related factors.Results FMC2A time,FMC2B time,FMC2S time and D2B time were shortened in the traditional channel group,green channel group and optimized green channel group.The rates of heart failure,cerebrovascular accident,non-factal myocardial infarction once again between the three groups had no statistical differences（P〉0.05）.Compared with the traditional channel group,the green channel group and the optimized channel group had lower mortality rates（P〈0.05）for various causes including cardiovascular disease during hospitalization,compared with the green chonnel group（P〉0.05）.During the follow-up period,the three groups of patients had no more fatal myocardial infarction,angina pectoris,angina pectoris,angina pectoris,angina pectoris,angina pectoris,angina pectoris（P〉0.05）.Compared with the traditional channel group,the green channel group and the optimized channel group were again hospitalized by heart disease,heart failure,heart source,heart rate,heart rate,heart rate and heart rate Sex and all-cause mortality was low（P〈0.05）.Conclusion The optimized green channel model can significantly reduce FMC2A time,FMC2B time,FMC2S time,D2B time,and improve clinical outcomes during and after PCI for half a year follow-up.
作者
张东霞
刘寒
许红娟
李文超
万玉艳
ZHANG Dongxia;LIU Han;XU Hongjuan;LI Wenchao;WAN Yuyan(Department of Emergency Internal Medicine,Xingtai People′s Hospital,Department of Emergency,Gaoyang County Hospital,Baoding,Hebei,Department of Medicine Tangshan City Fengnan District Hospita)
出处
《检验医学与临床》
CAS
2018年第4期499-502,共4页
Laboratory Medicine and Clinic
