急诊冠状动脉介入术前常规备抢救药物对患者预后的影响

Effect of Routine Preparation of Rescue Medications before Emergency Percutaneous Coronary Intervention on Patient Prognosis

目的观察急诊冠状动脉介入术(PCI)前常规备好抢救药品对患者临床预后的影响。方法将129例接受急诊PCI患者(急性ST段抬高型心肌梗死99例,急性非ST段抬高型心肌梗死30例)按随机数字表法分为观察组(术前准备抢救药品)和对照组(术前未准备抢救药品),比较2组术中术者发出指令至完成给药的耗时(TNU)、住院时间及医疗费用,术后第2周纽约心功能分级(NYHA)、NT-proBNP、左室射血分数。结果观察组和对照组TNU[(14±3)s比(122±20)s]、住院时间[(7±3)d比(9±5)d]、术后第2周左室射血分数[(62±19)%比(56±27)%]、NT-proBNP[(742±305)pg·mL^(-1)比(1273±359)pg·mL^(-1)]、心功能NYHAⅠ—Ⅱ级比率(86%比78%)比较,差异有统计学意义(均P<0.05)。观察组医疗费用较对照组要低[(28 462.52±9 753.70)元比(2 518.65±8 024.21)元,P<0.05]。结论急诊PCI术前常规备好抢救药物,可缩短抢救时的给药时间,改善患者临床预后,且不增加患者经济负担。

Objective To observe the effect of routine preparation of rescue medications before emergency percutaneous coronary intervention（PCI）on clinical outcomes.Methods One hundred and twenty-nine patients receiving emergency PCI（99 cases of acute ST-segment elevation myocardial infarction and 30 cases of acute non-ST-segment elevation myocardial infarction）were randomly divided into two groups：observation group（rescue medications were prepared preoperatively）and control group（rescue medications were not prepared preoperatively）.The time from need to use of medications（TNU）,hospital stay and medical costs were compared between the two groups.Furthermore,NYHA classification,N-terminal pro-brain natriuretic peptide（NT-proBNP）level and left ventricular ejection fraction（LVEF）were measured at week 2 after surgery.Results There were significant differences between the two groups in TNU（（14±3）seconds vs（122±20）seconds）,hospital stay（（7±3）days vs（9±5）days）,LVEF（（62±19）% vs（56±27）%）,NTproBNP level（（742±305）pg·mL^（-1） vs（1273±359）pg·mL^（-1））,percentages of patients classified as NYHA Ⅰ-Ⅱ（86% vs 78%）,and medical costs（28 462.52±9 753.70）yuan vs（2 518.65±8 024.21）yuan）.Conclusion The routine preparation of rescue medications before emergency PCI can shorten TUN,improve clinical outcomes and reduce economic burden of patients.