节假日对ST段抬高心肌梗死院内再灌注延迟的影响Effect of holidays on door-to-reperfusion time in patients with ST-segment elevation myocardial infarction
刘书山,胡大一,杨进刚,孙艺红,宋莉,王冉冉,张清潭,杜兰芳,李超,赵薇
摘要(Abstract)：
目的多中心、前瞻性观察节假日对急性ST段抬高心肌梗死(ST-elevation myocardial infarction,STEMI)患者院内再灌注延迟的影响。方法连续入选在北京市19个医疗中心自2005年11月至2006年7月至急诊室就诊并接受再灌注的STEMI患者共297例。分为节假日(春节、劳动节、国庆节、元旦、周末)和非节假日(星期一至星期五)再灌注治疗组。与非节假日再灌注治疗相比,分析节假日对进入医院门口(进门)-再灌注延迟的影响。结果297例患者中,节假日再灌注治疗组94例(31.6%),其中26例患者接受溶栓治疗,68例患者接受急诊PCI;非节假日再灌注治疗组203例(68.4%),其中61例患者接受溶栓治疗,142例患者接受PCI。在校正患者的各项因素后,节假日与进门-球囊扩张时间中位数[162.2min(95%CI:160.8,165.3)比141.8min(95%CI:137.8,144.1);P<0.01]及进门-溶栓时间中位数[64.1min(95%CI61.9,66.5)比50.1min(95%CI:48.3,54.5);P=0.03]延长显著相关。结论北京市在节假日接受再灌注治疗的STEMI患者进门-再灌注时间延迟增加。
关键词(KeyWords)： 心肌梗死;心肌再灌注;假日;时间安排
基金项目(Foundation): 首都紧急医学救援(5分钟)科技工程建设研究项目[京科技发(2005)593]资助
作者(Author): 刘书山,胡大一,杨进刚,孙艺红,宋莉,王冉冉,张清潭,杜兰芳,李超,赵薇
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