徐振兴,邱建平,王海容,黄辉,黄宇,林捷,陆纪德,阮长武

• 1:上海市浦东新区公利医院心血管内科

摘要(Abstract)：

目的探讨现场分诊能否缩短急性ST段抬高心肌梗死(STEMI)患者首次医疗接触至使用器械(C2D)时间。方法收集2010年3月至2014年2月就诊于浦东新区公利医院心内科并接受直接经皮冠状动脉介入治疗的222例STEMI患者的临床资料。根据治疗流程将患者分为两组:现场分诊组(121例)和非现场分诊组(101例)。主要分析指标为C2D时间;次要分析指标为进门至球囊扩张(D2B)时间及主要临床事件,包括肌钙蛋白I峰值、院内病死率及随访30 d病死率。结果现场分诊组患者C2D时间[(92.0±56.0)min比(131.0±61.0)min,P<0.01]、D2B时间[(55.0±26.0)min比(96.0±31.0)min,P<0.01]显著低于非现场分诊组;现场分诊组C2D时间小于90 min的比例显著高于非现场分诊组(98.3%比85.1%,P<0.01)。现场分诊组肌钙蛋白I峰值显著低于非现场分诊组[(23.5±22.0)μg/L比(43.5±39.0)μg/L,P<0.01]。两组患者院内病死率及随访30 d病死率比较,差异均无统计学意义(均P>0.05)。结论现场分诊显著缩短STEMI患者C2D时间和D2B时间,并使更多的患者C2D时间小于90 min。

关键词(KeyWords)： 心肌梗死;血管成形术;现场分诊;首次医疗接触至使用器械时间

Abstract:

Keywords:

基金项目(Foundation): 上海市卫生局青年科研项目(20124Y112)

作者(Author): 徐振兴,邱建平,王海容,黄辉,黄宇,林捷,陆纪德,阮长武

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