急性ST段抬高心肌梗死院前及院内一体化救治模式探讨

Study on an integrated approach to emergency management of the patients with acute ST-segment-elevation myocardial infarction

目的探讨急性ST段抬高心肌梗死(STEMI)院前→急诊室→导管室→监护室一体化救治模式的可行性及效果。方法对STEMI患者(GroupⅠ,n=16)采用一体化模式救治,再随机选取以往未采用本模式救治者23例(GroupⅡ),对比其进门至球囊扩张(door to balloon,D2B)时间。结果与以往相比,采用一体化模式救治D2B时间中位数由120min缩短至67min,MACE发生率由26.09%降至6.25%(P<0.001)。结论采用一体化模式救治STEMI可显著缩短进门至球囊扩张时间,显著改善患者预后。

Objective To study the feasibility and curative effect of an integrated approach（prehospital→emergency room→catheter lab→CCU）in emergency management of the patients with acute ST-segment-elevation myocardial infarction（STEMI）.Method 16 patients with STEMI（Group I）were treated with integrated approach and 23 patients（GroupⅡ）with STEMI who were not treated with integrated approach were randomly chosen as control group.The door-to-balloon（D2B）time was compared between the two groups.Result Compared with control group,median D2B time was significantly shortened from 120 minutes pre-protocol to 67 minutes post-protocol（P〈0.001）,and the patients had a better prognosis.Conclusion The integrated approach（prehospital→emergency room→catheter lab→CCU）can significantly reduce door-to-balloon time for the patients with STEMI and may remarkably improve their prognosis.