急性ST段抬高型心肌梗死患者院外急救医疗服务使用现状及影响因素

Current situation and influencing factors of prehospital emergency medical service in patients with acute ST-segment elevation myocardial infarction

目的探索急性ST段抬高型心肌梗死(STEMI)患者院外使用急救医疗服务系统(EMS)的现状及影响因素。方法选取2017年1月—2018年12月我院急诊科收治的STEMI患者,采用多因素Logistic回归分析STEMI患者院外使用EMS自救的现状及相关影响因素。结果共收集STEMI患者241例,男性176例(73.0%),年龄(61.26±13.24)岁;女性65例(27.0%),年龄(69.05±15.62)岁;采取院外自救125例(51.9%),年龄(62.47±14.46)岁;未采取院外自救116例(48.1%),年龄(64.31±14.15)岁。多因素Logistic回归分析结果显示,既往冠心病史和发病地点在家中是急性STEMI患者院外使用EMS的独立影响因素(D<0.05)。结论本研究急性STEMI患者中采取院外使用EMS的比例较低,意识薄弱,既往冠心病史和发病地点在家中是急性STEMI患者院外使用EMS的独立影响因素。应针对院外未使用EMS的STEMI患者以及公众进行相关知识培训或健康教育,进一步提高其自救互救意识和能力。

Objective Toexplore the influence of emergency medical service system(EMS)on patients with acute ST-eleva-tion myocardial infarction(STEMI).Methods We selected STEMI patients admitted tothe emergency department ofourhos-pital from January 2017 to December 2018,and used multivariate Logistic regression to analyze the current situation and re-lated influencing factors of pre-hospital EMS self-help for STEMI patients.Results A total of 241 STEMI patients(176males(73.0%)),61.26±13.24 years old,and 65 females(27.0%).(69.05±15.62)years old were collected.125 cases(51.9%)were treated with pre-hospital self-help,aged(62.47±14.46)years;1l6 cases(48.1%)were not treated with pre-hospitalself-help,aged(64.31±14.15)years.Multivariate Logistic regression analysis showed that previous history of coronaryheart disease and place of onset at home were independent factors for pre-hospital EMS use in acute STEMI patients(P<0.05).Conclusion In this study,a low proportion of acute STEMI patients received pre-hospital EMS,weak consciousness,previous history of coronary heart disease and place of onset at home were independent factors for pre-hospital EMS use inacute STEMI patients.Relevant knowledge training or health education should be conducted for STEMI patients who havenot used EMS before hospital and the public tofurtherimprove their awareness and ability of self-help and mutualrescue.