运用120进行院前急诊溶栓治疗AMI78例临床分析  

A Review of 78 Patients with AMI Treated by Acute Prehospital Thrombolysis

作　　者：郭维军[1] 薛锦彤 严士荣 纪鹏[1] 杨金友[2] 

机构地区：[1]江苏省淮安市淮阴医院心内科,223300 [2]江苏省淮阴卫校,223300

出　　处：《青海医药杂志》2006年第12期12-14,共3页Qinghai Medical Journal

摘　　要：目的:探讨基层医院急诊院前静脉溶栓治疗急性心肌梗塞的安全性和可行性。方法:利用我院120急救中心较为完善的急救体系,由心内科医师随120救护车出诊,在硬件条件许可和病人或(和)家人同意的情况下,在入院前开展急诊静脉溶栓治疗急性心肌梗塞。结果:符合溶栓指征的AMI病人170例,其中院前溶栓(A组)78例,院内溶栓(B组)79例,拒绝溶栓13例。共死亡7例,比较两组溶栓的病人发现,A组病人就诊到溶栓时间较B组缩短132.2 min[(35.8±14.3)min与(168.0±78.0)min](P<0.01),A、B组两组血管再通率分别为78.2%和51.9%(P<0.05),两组住院期间严重并发症发生率分别为6.4%和21.6%(P<0.05),病死率分别为2.6%和6.3%(P>0.05),住院天数A组较B组缩短9天[(14.5±7.8)d与(23.4±14.7)d](P<0.01)。结论:急诊院前静脉溶栓治疗急性心肌梗塞是安全的和可行的,为进一步提高急诊院前静脉溶栓率,需要普及AMI急救的知识。Objectives. To observe the safety and feasibility of acute prehospital thrombolysis for patients with acute myocardial infarction （AMI） in emergency. Methods： A total of 170 patients with AMI were enrolled in the study; of them 78 cases were performed the prehospital thrombolysis （group A）, 79 cases were treated through thrombolysis in the hospital （group B） and 13 refused the prehospital treatment. The results were compared between the two groups. Results： The mean intervals from episode to received acute thrombolytic therapy in group A and B was 35.8±14.3 minutes and 168. 0±78.0 minutes respectively （P〈0.01）. The vascular patency rates in group A and B was 78.2% and 51.9% resPectively（P〈0. 05）. The incidence rates Of severe complications was 6.4% and 21.6% in group A and group B respectively（P〈0.05）. The mortality rates of the group A and B in hospital was 2.6% and 6.3% respectively（P〈0.05）. The mean days of hospitalization were respectively 14.5 ± 7.8 d and 24.3 ± 14.7 d in group A and B. Conclusions; Acute prehospital thrombolytic therapy is safe and feasiblility for the patients with AMI in “120” emergency when the emergency system is available and strength.

关 键 词：院前 静脉溶栓 急性心肌梗塞 安全 

分 类 号：R542.22[医药卫生—心血管疾病]