健康宣教对急性ST段抬高心肌梗死患者院前救治延误的影响  

The effect of health education on pre-hospital delay in patients with ST-segment elevation myocardial infarction

作　　者：胡宪清[1] 金强松 周瑶瑶 倪瑜琦 蒋泽楠 傅慎文[1] 陈巧莉 赖长春 陈向东[4] 刘艳梅 HU Xianqing;JIN Qiangsong;ZHOU Yaoyao;NI Yuqi;JIANG Zenan;FU Shenwen;CHEN Qiaoli;LAI Changchun;CHEN Xiangdong;LIU Yanmei(First-author's address:Department of Cardiology,Jinhua Municipal General Hospital,Jinhua 321000,China)

机构地区：[1]金华市中心医院心内科一病区,321000 [2]武义县第一人民医院心内科 [3]永康市第一人民医院心内科 [4]磐安县人民医院心内科 [5]浦江县人民医院心内科

出　　处：《心电与循环》2023年第4期372-376,共5页Journal of Electrocardiology and Circulation

基　　金：金华市科技计划项目(2019-3-001b)。

摘　　要：目的 探讨健康宣教对急性ST段抬高心肌梗死(STEMI)患者院前救治延误的影响。方法 选取2020年1月至2023年5月在金华地区5家二级以上医院心内科就诊的552例STEMI患者为研究对象,均在发病24 h内接受经皮冠状动脉介入治疗。根据发病前是否接受过STEMI健康宣教分为宣教组85例和对照组467例,比较两组患者临床资料,采用多因素logistic回归分析STEMI患者院前救治延误(发病至到达医院时间≥120 min)的影响因素。结果 宣教组患者小学以上文化程度、家属是医务人员、有心绞痛病史、有冠心病家族史、合并心源性休克、造影时心肌梗死溶栓试验血流0级、血栓抽吸等比例均明显高于对照组,而院前救治延误比例明显低于对照组,发病至到达医院时间、总缺血时间均明显短于对照组,差异均有统计学意义(均P<0.05)。健康宣教(OR=0.463)、典型症状(OR=0.405)、呼叫120(OR=0.558)是STEMI患者院前救治延误的独立影响因素(均P<0.05)。结论 健康宣教能降低STEMI患者院前救治延误风险。Objective To evaluate the impact of health education on pre-hospital delay in patients with ST-segment elevation myocardial infarction(STEMI).Methods A total of 552 STEMI patients admitted to five secondary or higher-level hospitals in Jinhua area from January 2020 to May 2023 were included in this study.All patients received primary percutaneous coronary intervention(PCI)treatment within 24 hours of symptom onset.The patients were assigned to the education(n=85)and control(n=467)group according to whether they received health education on STEMI before the onset of the disease.Multivariate logistic regression was conducted to investigate the risk factors associated with pre-hospital delay,which was defined as a delay of≥120 min from symptom onset to hospital arrival.Results The prevalence of education level above primary school,a family member being medical staff,history of angina pectoris,family history of coronary heart disease,cardiogenic shock,thrombolysis in myocardial infarction flow grade 0 at angiography and rate of thrombus aspiration were higher in education group compared with those in the control group.However,the proportion of pre-hospital treatment delay,time from symptom onset to hospital arrival and the total ischemic time were all lower in education group compared with those in control group(P<0.05).Heath education(OR=0.463),typical symptoms(OR=0.405),and calling emergency services(OR=0.558)were independent risk factors for pre-hospital treatment delay in STEMI patients(all P<0.05).Conclusion Health education can reduce the risk of pre-hospital delay in STEMI patients.

关 键 词：健康宣教 院前救治延误 急性ST段抬高心肌梗死 经皮冠状动脉介入治疗 

分 类 号：R473.5[医药卫生—护理学]