急性心肌梗死院前与院内溶栓治疗的疗效比较

Comparison of Effects between Prehospital and Inhospital Thrombolytic Therapies on Acute Myocardial Infarction

目的探讨院前溶栓治疗急性心肌梗死的必要性及安全性。方法对象为2005年1月—2008年1月的急性心肌梗死患者72例,其中35例由我院急诊科进行院前溶栓治疗,37例进行院内溶栓,并将两者对比分析。结果发病至溶栓治疗时间,院前溶栓组为(108.29±29.05)min,院内溶栓组为(179.38±45.67)min。再通率院前组为71.43%,院内组为45.95%。心脏事件发生率院前组为11.43%,院内组为32.43%。两组相比差异有统计学意义(P(0.05)。结论对急性心肌梗死患者进行院前溶栓治疗能缩短发病至开始溶栓的时间,提高冠脉再通率,降低心脏事件发生率,是必要可行和安全的。

Objective To study the necessity and safety of prehospital thrombolytic treatment in patients with acute myocardial infarction （ AMI）. Methods Thirty-five patients with AMI in trial group received prehospital thromholytic treatment while another 37 ones in control group received inhospital thrombolytic treatment. Results The interval from onset to thrombolysis in the trial group was 71 minutes, shorter than that of the control group （ 108.29 ± 29.05 vs 179.38 ± 48.67 minutes, P 〈 0.05 ）. The rate of myocardial reperfusion was 71.43% in the trial group and 45.95% in the control grou.p, respectively （ P 〈 0.05 ）. The incidence of cardiac events was 11.43% in the trial group and 32.43% in the control group, respectively （ P 〈 0.05）. Conclusion Prehospital thromholytic therapy for AMI can shorten the interval from onset to thrombolysis, enhance the rate of myocardial reperfusion, and reduce the incidence of cardiac events. Thus, it is safe and necessary.