急性心肌梗死院前急救的临床价值与效果

Clinical value and effect of pre hospital first aid for acute myocardial infarction

目的 观察分析急性心肌梗死患者接受院前急救治疗的重要临床价值与效果,为提高救治成功率、改善患者预后提供借鉴。方法 本次研究抽取2019年10月—2021年3月天津市急救中心与天津市东丽医院合作救治的107例急性心肌梗死患者的临床资料,按照入院方式进行分组,其中55例由救护车送往医院并接受院前急救的患者为院前组,52例由家属送往医院接受常规流程救治的患者为常规组,比较两组患者抢救成功率、血管再通率、心功能指标(左室射血分数、左室舒张末内径)、住院时间、抢救时间、冠脉血流重建开始时间,分析院前急救临床效果。结果 院前组患者抢救成功率为89.09%,血管再通率为85.45%,高于常规组的73.08%、67.31%,差异均有统计学意义(P<0.05)。院前组患者治疗14 d后LVEF为(56.93±6.25)%,LVED为(53.17±4.62)mm,高于常规组的(50.19±8.03)%、(40.13±3.62)mm,差异均有统计学意义(P<0.05)。院前组住院时间、抢救时间以及冠脉血流重建开始时间均短于常规组,差异均有统计学意义(P<0.05)。结论 急性心肌梗死患者接受院前急救可有效降低死亡率,尽早实现血管再通,并改善心功能,提高救治效率,改善患者预后,可作为临床治疗路径加以推广应用。

Objective To observe and analyze the important clinical value and effect of pre hospital emergency treatment in patients with acute myocardial infarction,to provide reference for improving the success rate of treatment and improving the prognosis of patients. Methods This study extracted part of the clinical data of 107 patients with acute myocardial infarction treated by Tianjin Emergency Center and Tianjin Dongli Hospital from October 2019 to March 2021. They were grouped according to the admission mode,of which 55 cases sent to the hospital by ambulance and received pre hospital first aid were the pre hospital group,52 cases sent to the hospital by family members and treated according to the routine process were the routine group. The rescue success rate,vascular recanalization rate,and the indexes of cardiac function(left ventricular ejection fraction,left ventricular end diastolic diameter),hospital stay,rescue time and the start time of coronary blood flow reconstruction were analyzed. Results The rescue success rate and vascular recanalization rate were 89.09% and 85.45% in the pre hospital group,which were higher than those in the routine group with 73.08% and 67.31%,and the differences were statistical significance(P<0.05). After 14 days of treatment in the pre hospital group,the LVEF was(56.93±6.25)%,the LVED was(53.17±4.62)mm,which were higher than those in the routine group with(50.19±8.03)% and(40.13±3.62)mm,and the differences were statistical significance(P<0.05). The hospitalization time,rescue time and the start time of coronary blood flow reconstruction in the pre hospital group were shorter than those in the conventional group,and the differences were statistical significance(P<0.05). Conclusion Pre hospital first aid in patients with acute myocardial infarction could effectively reduce mortality,realize vascular recanalization as soon as possible,improve cardiac function,improve treatment efficiency,and improve patient prognosis,which could be popularized and applied as a clinical treatment path.