急性ST段抬高心肌梗死患者转运延迟的影响因素分析及干预措施

Influencing factors of transport delay in patients with acute ST segment elevation myocardial infarction and the intervention measures

目的分析急性ST段抬高心肌梗死患者转运延迟的影响因素,并就总结分析的影响因素结合医院实际情况拟定相应干预措施。方法选取2018年1月至12月本院收治的90例患者资料,根据决定就医后是否1h内送达指定医院为依据分为两组,分别命名为短转运组和长转运组。通过收集两组患者相关资料录入统计学软件进行总结分析。结果 患者延迟导致转运时间为(90.23±9.59)min,院前延迟导致转运时间为(159.48±10.26)min;经多因素分析周围有人(OR=2.264)、症状难以忍受(OR=2.094)、自行转运(OR=1.820)、不愿打扰别人(OR=2.314)、等待症状消失(OR=2.115)、重视症状(OR=2.675)、服用非硝酸酯类药物(OR=2.186)、症状混淆(OR=2.499)为转运时间长的因素。结论 临床医务人员应广泛宣传急性ST段抬高型心肌梗死的症状和自我治疗的认知程度,增强患者对急性ST段抬高型心肌梗死尽早转运的意识,并提倡拨打急救电话应用急诊医疗服务车进行转院。

Objective To analyze the influencing factors of transport delay in patients with acute ST segment elevation myocardial infarction (AMI), and to draw up corresponding intervention measures according to the hospital’s actual situation. Methods The data of 90 patients admitted from January to December, 2018 were divided into a short transfer group and a long transfer group according to the decision whether to reach the designated hospital within 1 hour after the treatment. The related data in both groups were collected, and input the statistical software for summary analysis. Results The average time of transport caused by delay in the patients was (90.23±9.59) min, and the average time of transport was (159.48±10.26) min. Multivariate analysis showed that people around (OR=2.264), unbearable symptoms (OR=2.094), self-transport (OR=1.820), unwilling to disturb others (OR=2.314), waiting for the symptoms to disappear (OR=2.115), attention to symptoms (OR=2.675), taking non-nitrate drugs (OR=2.186), and symptom confusion (OR=2.499) were factors causing the long transfer. Conclusion Clinical medical staff should widely publicize the symptoms of acute ST segment elevation myocardial infarction and the degree of self-treatment, enhance the patients' awareness of the early transport of acute ST segment elevation myocardial infarction, and advocate to dial the first aid telephone to apply the emergency medical service car to carry on the hospital transfer.