急性ST段抬高型心肌梗死院前转运PCI治疗体会

摘要

Objective To observe the better pre-hospital transfer of acute ST segment elevation myocardial infarction (STEMI) patients directly the effect of PCI.Methods Collected in May 2015, in May 2016 with acute ST segment elevation myocardial infarction (STEMI) via optimization of emergency transport admission line direct PCI treatment data of 33 patients to observe group (group A), collected in March 2014-May 2015 for STEMI data via the non-optimized emergency transport direct PCI treatment data 37 patients as control group (group B), the onset time within 12h.Compare two groups of patients with medical treatment for the first time contact to balloon dilation (FMC-to-B) time, the door to balloon dilation (D-to-B) time, into the international to balloon expansion time, the door to international time, length of hospital stay, hospital expenses and other indicators have difference.Results observation group FMC-to-B and D-to-B, into the international to balloon expansion time, the door to international time respectively (111.3± 35.7), (76.7± 35.0),(35.7± 8.5), (16.9± 5.1) minwere significantly lower than the control group , respectively (147.3± 36.7), (89.7± 39.6), (46.8± 9.7) (36.7± 8.3)min, (P<0.05).Team of hospital stay (9.0± 4.3) d than (9.8± 4.7) dand hospitalization expenses RMB (51253± 22108) yuan than (57156± 25619) yuan is lower than the control group (P<0.05).Conclusion pre-hospital transfer significantly shorten the FMC better-to-B and D-to-B of time, can improve the curative effect in patients with STEMI PCI, patients to reduce the economic burden.%目的：观察采用更优化的院前转运对急性ST段抬高型心肌梗死（STEMI）患者直接PCI疗效的影响。方法收集2015年5月-2016年5月因急性ST段抬高型心肌梗死（STEMI）经优化急救转运入院行直接PCI治疗33例患者资料为观察组（A组），收集2014年3月--2015年5月期间因STEMI经未优化急救转运直接PCI37例患者资料为对照组（B组），发病时间均在12h之内。比较两组患者首次医疗接触至球囊扩张（FMC-to-B）时间、进门至球囊扩张（D-to-B）时间、进导管室至球囊扩张时间、进门到导管室时间、住院时间、住院费用等指标有无差别。结果观察组FMC-to-B、D-to-B、进导管室至球囊扩张时间、进门到导管室时间分别为（111.3±35.7）、（76.7±35.0）、（35.7±8.5）、（16.9±5.1）min均明显低于对照组分别为（147.3±36.7）、（89.7±39.6）、（46.8±9.7）、（36.7±8.3）min， P均＜0.05。研究组住院时间（9.0±4.3）d比（9.8±4.7）d及住院费用（51253±22108）元比（57156±25619）元低于对照组（P均＜0.05）。结论采用更优化的院前转运明显缩短FMC-to-B、D-to-B时间，能够改善STEMI患者直接PCI疗效，减轻患者经济负担。