AMI急诊静脉内溶栓疗法应用延迟时间相关因素

STUDY ON THE INTRAVENOUS THROMBOLYSIS DELAY IN EMERGENCY PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

目的探讨急性心肌梗死急诊静脉内溶栓疗法应用延迟时间的相关因素。方法对204例进行急诊静脉内溶栓治疗的急性心肌梗死病人的临床资料进行回顾性分析。结果本组204例中在院前和急诊科进行溶栓治疗者分别占11.3%和88.7%。全部病人总平均延迟时间为(203.1±92.9)min,其中进行院前溶栓的延迟时间明显短于在急诊科进行溶栓治疗者。溶栓治疗延迟时间与病人年龄呈正相关(r=0.308,P<0.05)。在发病后3h内进行溶栓的病人63例,其院内严重并发症的发生率低于3h后开始溶栓者(χ2=2.886,P<0.05)。结论急性心肌梗死急诊溶栓治疗的延迟时间与病人年龄及院内严重并发症的发生有一定的关系,院前进行溶栓治疗可显著缩短溶栓开始时间。

Objective To evaluate the related factors of intravenous thrombolysis treatment delay in the emergency patients with acute myocardial infarction （AMI）. Methods Clinical data of 204 AMI patients received emergency intravenous thrombolysis therapy were analyzed retrospectively. Results In 204 patients reviewed, those received intravenous thrombolysis therapy before hospitalization accounted for 11.3%, while those received thrombolysis therapy in the emergency department accounted for 88.7%. The average delay time of therapy all the patients was （203. 1±92.9）min, in which, the delay of those underwent prehospital therapy was markedly shorter than those treated in emergency room. The deferred time of thrombolysis therapy was positively correlated with the patient＇s age （r=0. 308,P〈0.05）. In 63 patients who received therapy within 3 h after the attack, whose severe complications were lower than those treated later than 3 h （χ^2 =2. 886,P〈0.05）. Conclusion The delay of intravenous thrombolysis is correlated with the age and in-hospital severe complications in AMI patients, and prehosptial thrombolysis can dramatically shorten the delay.