193例急性ST段抬高型心肌梗死患者的院前急救

Study on Pre-hospital Emergency in the Treatment of 193 Patients With ST-segment Elevation Myocardial Infarction

目的探讨急性心肌梗死患者的病因构成,早期溶栓治疗及提高院前院内对接的抢救流程。方法对本科室2013年1月1日~2015年12月31日接诊的193例急性ST段抬高型心肌梗死患者回顾性分析,并进行院内跟踪。结果 193例急性ST段抬高型心肌梗死患者中,高血压118例,高血脂43例,糖尿病25病,不明原因7例。急救结果 ：病情稳定158例,心源性休克6例,恶性室性心律失常9例,院前死亡20例,院内死亡14例,总死亡34例。结论急性心肌梗死患者的病因主要为高血压和高脂血症,但合并有糖尿病的患者,病情进展快,死亡率高。院前急救提倡全程监护、稳定血压和心率,及时送有条件行经皮冠状动脉介入术（PCI）和冠状动脉旁路手术（CABG）的医院,早期进行溶栓及介入治疗,有利于提高抢救成功率。

Objective To investigate the etiology of patients with acute myocardial infarction,thrombolytic therapy and improve prehospital hospital docking rescue process. Methods 193 cases of patients with ST-segment elevation myocardial infarction from Jan. 1st,2013 to Dec. 31 st,2015,were retrospectively analyzed in the hospital. Results Among the 193 acute ST-elevated myocardial infarction patients,118 cases were caused by hypertension,43 cases were caused by hyperlipidemia,25 by diabetes,and 7 from unknown reason. Rescue results： After rescue,158 patients were in stable conditions. However,6 cardiogenic shock cases,9 ventricular arrhythmia cases,34 dead cases,in which 20 were in pre-hospital stage,and 14 in the hospital. Conclusion The main inducement of acute myocardial infarction is hypertension and hyperlipidemia,and the patients with diabetes have rapid deterioration and high mortality. For pre-hospital first aids,it is suggested to perform continuous monitoring on the patients and stablize their blood presure and heart rate. Sending the patients to the hospital which is able to implement the percutaneous coronary intervention（PCI） and coronary artery bypass surgery（CABG） in time and making early thrombolytic interventional therapy will benefit to improve the success rate of rescue.