不同转运方式对急性心肌梗死患者再灌注治疗延迟的影响  

Influence of different transportation mode on repurfusion time in patients with acute myocardial infarction

作　　者：宋莉[1] 颜红兵[1] 程姝娟[1] 王健[1] 赵汉军[1] 李世英[1] 李庆祥[1] 郑斌[1] 迟云鹏[1] 吴铮[1] 

机构地区：[1]首都医科大学附属北京安贞医院心内科28病区,100029

出　　处：《中国介入心脏病学杂志》2010年第3期147-150,共4页Chinese Journal of Interventional Cardiology

基　　金：首都紧急医学救援(5分钟)科技工程建设研究项目组子课题之一[京科技发(2005)593]的部分资助

摘　　要：目的比较不同转运方式对ST段抬高心肌梗死(STEMI)患者再灌注治疗延迟的影响。方法单中心现况调查。入选2006年1月1日至2007年4月30日期间,于发病24h内就诊于北京安贞医院抢救中心的232例STEMI患者。根据转运方式分为救护车组和自行转运组,比较两组各时间间隔:(1)决定就医-首次医疗接触;(2)决定就医-进门;(3)决定就医-球囊扩张;(4)进门-球囊扩张;(5)发病-球囊扩张。结果 105例(45.3%)STEMI患者通过救护车转运到达医院,其余127例(54.7%)为自行转运。自行转运组决定就医-进门时间显著短于救护车组(中位数,35min比50min,P<0.001)。而救护车组的决定就医-首次医疗接触(中位数,15min比35min,P<0.001)、决定就医-球囊扩张(中位数,173min比193min,P=0.049)、进门-球囊扩张(中位数,102min比125min,P<0.001)以及发病-球囊扩张时间(中位数,223min比300min,P<0.001)均显著短于自行转运组。结论尽管自行转运可更快到达医院,但是救护车转运可更快获得再灌注治疗。Objective To investigate the differences in delay of reperfusion therapy for patients with ST-elevation myocardial infarction （STEMI） who used ambulance services versus private transportation.Methods The study was a cross-sectional and single center registry.Data were collected from the 232 patients with STEMI admitted within 24 hours of symptom onset to the Emergency Department of Beijing Anzhen Hospital between January 1,2006 and April 30,2007.Time consumed to definitive medical care was examined in terms of different time segments as：（1） decision to seek care to first medical contact;（2） decision to seek care to hospital arrival;（3） decision to seek care to reperfusion therapy;（4） door to balloon time;and （5） symptom onset to reperfusion therapy.Results Only 105 （45.3%） patients with STEMI used ambulance services,and the remaining 127 （54.7%） presented by private transport.Private transportation resulted in faster hospital arrival than using ambulances （median,35 vs.50 min,P0.001）.However,using ambulance resulted in shorter decision to seek care to first medical contact （median,15 vs.35 min,P0.001）,decision to seek care to balloon （median,173 vs.193 min,P=0.049）,door to balloon （median,102 vs.125 min,P=0.049）,and symptom onset to balloon （medians,223 vs.300 min,P 0.001） times compared with patients using private transportation.Conclusion Although private transportation results in a faster trip to the hospital,quicker definitive care is obtained with the use of ambulance.

关 键 词：心肌梗死 救护车 病人转送 再灌注 

分 类 号：R473.5[医药卫生—护理学]