韶关市农村急性心肌梗死患者再灌注治疗现状分析

Analysis of reperfusion therapy in rural patients with acute myocardial infarction in Shaoguan city

目的通过调查了解韶关地区4县农村急性ST段抬高型心肌梗死（acute st-segment elevation myocardial infarction，STEMI）再灌注治疗现状，分析与指南存在的差距，探讨改善措施，以提高STEMI的治疗质量。方法采取查阅患者住院病历和电话、门诊回访相结合的方法，收集742例韶关市农村STEMI患者的再灌注治疗情况。结果①入选病例中STEMI患者742例，283例（38．1％）接受再灌注治疗，其中采用静脉溶栓治疗的120例（16．2％），163例（22．0％）患者选择转院行转运PCI治疗。②接受溶栓治疗的患者FMC-溶栓进针时间中位数为2．20h，溶栓延迟时间中位数为1．7h。③接受溶栓治疗的患者发病-溶栓进针中位数时时为6．35h，发病3h内溶栓者占21．6％，发病12h内溶栓者占92．5％。结论目前韶关市农村STEMI再灌注治疗比例仍较低，就诊及溶栓治疗延迟现象较明显，与指南要求差距较大。

Objective To investigate the status quo of reperfusion therapy of acute st-segment elevation myocardial infarction （STEM1） in rural areas of Shaoguan city, analyze its gap with the guidelines, explore the improvement measures to improve the treatment quality of STEM1. Method Collected the medical records and telephone, clinic visit to investigate reperfusion therapy in 742 rural patients with STEMI in Shaoguan city. Results ① There were 742 cases of STEMI, 38.1% of the patients underwent reperfusion treatment. Among them, 16.2% of the patients were treated with intravenous thrombolysis, and 22.0% of the patients were treated with transport PCI.② The median time of FMC-thrombolysis therapy in patients treated with intravenous thrombolysis was 2.20 hours, the median thrombolysis delay time was 1.7 hours. ③ The median time from onset to thrombolytic therapy of patients treated with intravenous thrombolysis was 6.35 hours, patients from onset to thrombolytic therapy within 3 hours accounted for 21.6%, patients from onset to thrombolytic therapy within 12 hours accounted for 92.5%. Conclusion At present, the proportion of reperfusion therapy of patients with STEMI in rural areas of Shaoguan city is still low, the delay phenomenon of thrombolysis treatment is obvious, and the gap between it and the guidelines is large.