区域胸痛中心建设对不同年龄段ST段抬高型心肌梗死救治现状  

The Current Situation of the Construction of Region Chest Pain Center for the Treatment of ST Segment Elevation Myocardial Infarction in Different Age Groups

作　　者：王有龙 李雪 董建军 吴亚蓉 戴海龙 吕宁 WANG Youlong;LI Xue;DONG Jianjun;WU Yarong;DAI Hailong;LYU Ning(Anning First People's Hospital,Yunnan Province,Anning 650300,China;不详)

机构地区：[1]云南省安宁市第一人民医院,云南安宁650300 [2]昆明医科大学附属延安医院

出　　处：《中国医学创新》2023年第7期153-157,共5页Medical Innovation of China

基　　金：云南省科技厅科技计划项目(2019FE001(-267));昆明市卫生科技项目(2018-03-01-006)。

摘　　要：目的:研究区域胸痛中心不同年龄段的急性ST段抬高型心肌梗死(STEMI)患者救治的现状。方法:纳入安宁市第一人民医院胸痛中心2017年1月-2020年12月救治的275例急性STEMI患者,按年龄将研究对象分为青年组、中年组和老年组。收集病例的一般资料、来院方式、发病到首次医疗接触(S2FMC)时间、治疗方案、双绕行、首次医疗接触-导丝通过(D2B)时间、造影结果、再灌注延迟原因、罪犯血管和血流信息,利用统计学方法分析及描述区域胸痛中心不同年龄段再灌注治疗现状及其影响因素。结果:(1)STEMI患者以老年、男性患者最常见;(2)患者来院方式为自行来院、网络医院转入、120呼叫和院内发病,不同组别来院方式差异无统计学意义(P>0.05);(3)不同组别双绕行、治疗方案、罪犯血管和血流信息差异均无统计学意义(P>0.05);(4)所有入组患者发病后最短就诊时间13 min,最长1956 min。患者12 h内就诊235例,青年组患者S2FMC时间>12 h的占比较中老年组S2FMC更多;(5)STEMI患者D2B中位数为82.10 min,再灌注延迟原因主要包括:家属未到场、知情同意时间过长、术中并发症延误、术前并发症延误和医生决策延迟,不同组别患者D2B时间分布差异无统计学意义(P>0.05)。结论:青年STEMI患者的S2FMC时间较中老年组显著延长,提示老年组患者受到心肌类疾病的宣教效果比较好,下一步不但要积极加强社区宣教,同时也要宣教范围扩大,在青年人群中进行宣传。Objective:To investigate the current status of acute ST-segment elevation myocardial infarction(STEMI)in different age groups after the establishment of a region chest pain center.Method:A total of 275patients with acute STEMI were enrolled in Anning First People’s Hospital from January 2017 to December 2020.According to the age,the subjects were divided into the young group,the middle-aged group,and the elderly group.The general information,ways of coming to the hospital,symptom onset-to-first medical contact(S2FMC)time,treatment plan,double bypass,door-to-balloon(D2B)time,angiography results,reasons for reperfusion delay,prisoners’blood vessels and blood flow information were collected.Statistical methods were used to analyze and describe the current situation of reperfusion treatment at different age groups and its influencing factors in chest pain centers in counties.Result:(1)STEMI patients were most commonly elderly and male patients.(2)Patients came to the hospital by themselves,network hospital transfer,120 call and in-hospital onset,and the difference in the mode of arrival between different groups was not statistically significant(P>0.05).(3)The differences in double bypass,treatment plan,offender vessel and blood flow information between different groups were not statistically significant(P>0.05).(4)All enrolled The shortest visit time after onset was 13 min and the longest was 1956 min.235 patients were seen within 12 h.More patients in the youth group had S2FMC time>12 h than in the middleaged and elderly group had S2FMC.(5)The median D2B of STEMI patients was 82.10 min,and the main reasons for delayed reperfusion included:family non-arrival,long informed consent time,intraoperative complications delay,delayed preoperative complications and delayed physician decision making,and the differences in the distribution of D2B time among different groups of patients were not statistically significant(P>0.05).Conclusion:The duration of S2FMC is significantly longer in young STEMI patients than in the mid

关 键 词：区域胸痛中心建设 急性ST段抬高型心肌梗死 不同年龄段 再灌注治疗 

分 类 号：R542.22[医药卫生—心血管疾病]