基层医院急性ST段抬高型心肌梗死再灌注治疗策略

Reperfusion therapy strategy for acute ST-segment elevation myocardial infarction in primary hospital

随着我国人民生活水平的提高和生活方式的改变,冠心病成为死亡的首要原因,其中急性心肌梗死(AMI)具有死亡率高、致残率高、发病凶险等特点,日益受到人们重视。AMI分为ST段抬高型心肌梗死(STEMI)和非ST段抬高型心肌梗死,其中STEMI最为危重。根据相关数据统计,基层医院约接诊70%STEMI患者,成为救治STEMI的主战场,由于医疗条件的限制,溶栓治疗是目前基层医院实施STEMI再灌注治疗的必然选择,不过由于治疗策略欠缺规范,导致基层医院的STEMI再灌注治疗具有一定的困难。为快速有效治疗STEMI患者,本文结合《2010急性ST段抬高型心肌梗死诊断和治疗指南》、《2015急性ST段抬高型心肌梗死诊断和治疗指南》,及相关文献将基层医院STEMI再灌注治疗的策略作如下总结。

With the improvement of people’s living standard and the change of life style,coronary heart dis ease has become the leading cause of death,among which acute myocardial infarction(AMI)has the characteristics of high mortality,high disability rate,and dangerous morbidity,and has attracted increasing attention.AMI is divided into ST-segment elevation myocardial infarction(STEMI)and non-ST-segment elevation myocardial infarction,of which STEMI is the most critical.According to relevant data statistics,primary hospitals receive about 70%of STEMI patients,and have become the main battlefield of STEMI treatment.Thrombolytic therapy is the inevitable choice for primary hospitals to implement STEMI reperfusion therapy due to the limitation of medical conditions.However,due to the lack of standardization of treatment strategies,this leads to have certain difficulties in STEMI reperfusion treatment in primary hospitals.In order to treat STEMI patients quickly and effectively,this review summarizes the strategies of STEMI reperfusion therapy in primary hospitals in combination with the Guidelines for Diagnosis and Treatment of Acute ST-segment Elevation Myocardial Infarction 2010,Guidelines for Diagnosis and Treatment of Acute ST-segment Elevation Myocardial Infarction 2015 and related literature.