不同院前急救模式对急性冠脉综合征疗效的影响探讨

Efficacy of different pre-hospital care modes in acute coronary syndrome

目的探讨不同院前急救模式对急性冠脉综合征(ACS)疗效的影响。方法采取横断面研究方法,于我省选取4家急救中心2017年1月—2018年12月间共196例院前急救ACS患者的临床资料开展分析与调查,根据院前急救模式差异分成依托型组、指挥型组、院前型组与独立型组各49例,探讨几种院前急救模式对ACS疗效的影响。结果指挥型组的出车距离较依托型组短,指挥型组的反应时间较院前型组及依托型组短,指挥型组到达时间较独立型组及依托型组长,指挥型组处理时间较独立型组及院前型组短,指挥型组总时间较院前型组及依托型组短(P<0.05)。4组在心电图、硝酸酯、阿司匹林、建立静脉通路及生命监护方面差异显著(P<0.05)。独立型组的治疗有效率是71.43%,显著较院前型的38.78%高(P<0.05)。结论在所有的ACS院前急救模式当中,独立型疗效最佳,院前型现场初步处置处理得最好,予以ACS患者硝酸酯类药物口服对提高其疗效具有重要作用。

Objective To study the efficacy of different pre-hospital care modes in acute coronary syndrome(ACS).Methods Through the cross-sectional study,196 ACS patients treated from January 2017 to December 2018 were reviewed.According to different pre-hospital care modes,patients were assigned to depending type group,directive type group,pre-hospital type group and independent type group,49 cases in each group.The efficacy was probed.Results The riding distance in directive type group was shorter than depending type group;the response time in directive type group was shorter than pre-hospital type group and depending type group;the arrival time in directive type group was longer than independent type group and depending type group;the processing time in directive type group was shorter than independent type group and pre-hospital type group;the overall time in directive type group was shorter than pre-hospital type group and depending type group;the electrocardiogram results,usage of nitrate and aspirin,venous channel establishment and life monitoring among groups were significantly different(P<0.05);the effective rate in independent type group(71.43%)was significantly higher than pre-hospital type group(38.78%)(P<0.05).Conclusion The independent type has most favorable effect in ACS patients while the pre-hospital type makes for site disposal.Besides,the oral medication of nitrate is of great importance in clinical practice.