海岛地区区域协同救治体系对急性ST段抬高型心肌梗死患者救治时间及短期疗效的影响

Effect of island regional synergistic treatment system on the treatment time and short-term therapeutic efficacy of ST-segment elevation myocardial infarction

目的探讨海岛地区区域协同救治体系对急性ST段抬高型心肌梗死(STEMI)患者有效救治时间及短期疗效的影响。方法回顾分析2016年1月至2018年12月从岛际转运过来的STEMI患者资料,以海岛急性胸痛区域协同救治体系建立前后分为对照组和观察组,比较首诊医院溶栓并早期岛际转运急诊经皮冠状动脉介入(PCI)治疗患者的例数,首次医疗接触-球囊扩张(FMC2B)时间,入门-球囊扩张(D-to-B)时间,住院后主要心脏不良事件(MACE)及住院时间。结果对照组30例,观察组46例。观察组首诊医院实行溶栓并早期岛际转运的患者例数均明显多于对照组(P<0.01或0.05)。与对照组比较,观察组FMC2B时间、D-to-B时间、住院期间MACE发生减少,住院时间明显缩短,差异均有统计学意义(均P<0.01)。结论海岛地区区域协同救治体系建设能有效缩短海岛STEAMI患者的急诊有效救治时间,减少MACE发生率,缩短住院时间。

Objective To explore the effect of island regional synergistic treatment system on the treatment time and short-term prognosis of patients with ST-segment elevation myocardial infarction(STEMI). Methods The clinical data of STEMI patients transferred from other islands from July 2016 to December 2018 were analyzed retrospectively. All patients were divided into group A and B according to the date the acute chest pain area co-treatment system established. The number of cases with thrombolytic treatment in primary hospital and transferred for primary PCI, the time from first medical contact to balloon dilatation(FMC2 B), and the time from entering hospital to balloon dilatation(D2 B), major cardiac adverse events(MACE) and hospitalization time were compared between two groups. Results There were 30 STEAMI patients in group A and 46 in group B. The number of patients who underwent thrombolysis and early inter-island transport in the index hospital were significantly higher in group B than in group A(P<0.05). FMC2 B time, D-to-B time, the incidence of MACE and hospitalization time were significantly shorter in group A than in group B(all P<0.01). Conclusion The establishment of island regional synergistic treatment system can shorten emergency treatment time and hospitalization time and reduce MACE of patients with STEMI.