基层医院开展急性心肌梗死“绿色通道”的研究  

Research on green passage for acute myocardial infarction in basic hospital

作　　者：梁健球[1] 熊华峰[1] 徐宁[1] 黄永光[1] 吴庆庆[1] 陈美玉[1] 张震洪[1] 王玉燕[1] 欧小敏[1] 刘怀昌[1] 

机构地区：[1]佛山市第二人民医院,广东佛山528000

出　　处：《岭南心血管病杂志》2007年第4期241-244,共4页South China Journal of Cardiovascular Diseases

基　　金：佛科(2005)71号;200508055

摘　　要：目的探讨市级基层医院开展急诊经皮冠状动脉介入术绿色通道的可行性、安全性和有效性。方法对怀疑急性心肌梗死病人分为绿色通道组和非绿色通道组进行治疗,比较两组梗死相关血管再灌注时间、经皮冠状动脉介入术成功率、病死率、30d主要心血管事件、血B型利钠肽及左心室射血分数等指标。结果绿色通道组梗死相关血管再灌注时间较非绿色通道组明显缩短,降低病死率、30d主要心血管事件发生率以及术后7dB型利钠肽,改善心功能,差异有统计学意义;但住院时间和围术期成功率差异无统计学意义。结论B型利钠肽可作为急性心肌梗死病人急诊经皮冠状动脉介入术后早期心功能的预测指标;基层医院开展急性心肌梗死绿色通道可有效和安全地开展治疗急性心肌梗死。Objectives To investigate the feasibility, security and curative effect of green passage for primary percutaneous coronary intervention （PPCI） in basic hospital. Methods Patients with AMI were divided into two groups of PCI before divided randomly. Control group （Non green passage group） was received routine treatment. Green passage was received emergency PCI. Reperfution time, achievement ratio, mortality, main artery cardiac events （MACE） in 30 days, brain natriuretic pepide （BNP） in the first and seventh day and LVEF in the first an fourth week were measured. Rusults Compared with control group, reperfution time, mortality, MACE and the level of BNP on seventh day were cut down significantly with the improvement on heart function in green passage group （P〈0.05）. On length of stay （LOS） and achievement ratio of PCI between two groups were not statistically significant. Conclutions BNP may be the predictive index on the heart function after PCI. In basic hospital, the development of green passage for AMI was feasible, safety and effective which might shorten the reperfution time, improve the heart function after AMI, enhance the survival rate and decrease the accident of MACE.

关 键 词：心肌梗死 绿色通道 冠状动脉介入术 基层医院 

分 类 号：R542.22[医药卫生—心血管疾病] R815[医药卫生—内科学]