目的:比较优化的急救绿色通道与常规通道2种途径直接经皮冠状动脉介入治疗 (PCI)对急性ST 段抬高心肌梗死(STEMI)首次医疗接触至球囊扩张 (FMC2B)时间及急诊PCI预后的影响. 方法:STEMI患者183例,分为优化的绿色通道组及常规通道组,观察FMC2B、就诊至球囊扩张(D2B)时间、住院及随访期间主要心血管事件发生率,并分析心血管事件相关危险因素. 结果:与常规通道组比较,绿色通道组患者的FMC2B、D2B时间显著缩短(100.3 min vs. 145.6 min;77.1 min vs. 115.4 min,均P < 0.05),住院期间死亡率较低(5.0% vs. 15.7%,P < 0.05),随访期间再次因心源性疾病入院、全因死亡及心源性死亡率均明显低于常规通道组(均P < 0.05). 结论:优化的绿色通道模式可显著缩短FMC2B、D2B时间,并改善近、远期临床预后.%Objective To evaluate the influence of different clinic pathways on the time from first medical contact to balloon (FMC2B) and the time from door to balloon (D2B) for emergency patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention as well as the prognosis. Methods 183 consecutive patients were divided into emergency easy access group and normal access group. The two groups were compared in terms of the FMC2B time, D2B time and outcomes during hospitalization and follow-up. Results Compared with the normal access group, the FMC2B time in the emergency easy access group was significantly shorter (100.3 min vs. 145.6 min, P < 0.05) and so it was with the D2B time (77.1 min vs. 115.4 min, P<0.05). Meanwhile, in-hospital mortality was significantly lower (5.0%vs. 15.7%, P<0.05). The follow-ups showed the rates of re-hospitalization related to heart diseases, and the mortality rate of cardiovascular disease were significantly lower in the emergency easy access group. Conclusion The optimized emergency easy access could reduce the FMC2B time and D2B time and improve the prognosis of patients with STEMI.
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