远程实时传输12导联心电图对急性ST段抬高性心肌梗死患者的门-球时间的影响  

Study on the Impacts of remote real-time transmission 12-lead electrocardiogram system on door-to-balloon time in patients with ST-segment elevation myocardial infarction

作　　者：罗望胜[1] 向定成[2] 张金霞[2] 

机构地区：[1]南华大学附属第一医院,湖南省衡阳421001 [2]广州军区广州总医院心血管内科

出　　处：《中华急诊医学杂志》2015年第10期1155-1159,共5页Chinese Journal of Emergency Medicine

基　　金：广州市科技计划专项（穗科信字2011179号）;广州市科技计划项目（2012J4300107）广东省科技计划重点项目（2011A011304002）;广东省科技计划重大项目（2012A080104020）

摘　　要：目的 评价12导联心电图远程实时传输系统对进行直接经皮冠状动脉介入治疗的ST段抬高性急性心肌梗死（STEMI）患者门-球时间的影响.方法 2012年2月至2012年7月就诊于广州军区广州总医院胸痛中心的进行直接PCI的STEMI的患者的临床资料进行分析,分为院前传输心电图组（采用12导联心电图远程实时传输系统将患者心电图传输至胸痛中心）和无院前心电图组.主要分析指标：进门至导管室时间、门-球时间.次要分析指标：门-球时间达标率、手术占台率、院内病死率、住院天数.结果 研究期间共入选60例患者,其中院前心电图为35例,无院前心电图为25例,院前心电图可显著缩短进门一球时间（中位数,38 min vs.94 min;P＜0.01）,院前心电图组门-球时间低于90 min的达标率显著高于无院前心电图组（94.6％：60％;p=0.001）,院前心电图手术占台率明显低于无院前心电图（5.7％vs.40％;P=0.001）,住院时间则显著短于无院前心电图组（P＜0.01）.2组患者住院期间病死率组间比较差异无统计学意义（P＞0.05）.结论 远程实时传输12导联心电图显著缩短STEMI患者门-球时间.Objective This study was aimed to evaluate the remote real-time transmission 12-lead electrocardiogram system on door-to-balloon time in patients with ST-segment elevation myocardial infarction.Methods We retrospectively analyzed the consecutive patients with STEM I who had accepted primary percutaneous coronary intervention （PCI） in the chest pain center of our hospital from February 2012 to July 2012.The study group consisted of patients with pre-hospital ECG,while the control group included patients without pre-hospital ECG,Their door-to-balloon time and door-to-catheter room time,mortality w ere compared.Results Totally 60 consecutive patients who had received primary PC I for STEMI were evaluated.Among them,35 patients were hospitalized with pre-hospital ECG while the other 25 patients without ECG.The Pre-hospital ECG was associated with a significautly shorter median door-to-balloon time （38 min vs.94min;P 〈0.01）,The proportion of patients received balloon dilation within the guidelinerecommended 90 min timeframes Was significantly higher in pre-hospital ECG group than in non pre-hospital ECG group （94.6% vs.60%;P =0.001）.No difference was observed in mortality between the two groups （5.7%vs.4%;P 〉 0.05）,Significant difference was seen in the median hospital time in study group （5 compared with control group （7day） （5 day vs.7 day;P 〈 0.01）.Conclusions The remote real-time transmission 12-lead electrocardiogram system is associated with a significantly shorter door-to-balloon time in STEMI patients.The remote real-time transmission 12-lead electrocardiogram system is recommended in patients suspected STEMI.

关 键 词：急性ST段抬高性心肌梗死 院前心电图 门一球时间 无线心电图/远程心电图 实时 远程医疗 远程心电监测 无线/3G 院前诊断 

分 类 号：R542.22[医药卫生—心血管疾病]