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目的分析绕行经皮冠状动脉介入(PCI)救治时间对急性ST段抬高型心肌梗死(STEMI)病人的价值。方法收集2011年8月—2015年7月发病12h内接受急诊PCI的STEMI病人232例。绕过急诊室、冠心病监护病房或普通心脏病房直接将病人送入导管室行急诊PCI者72例纳入绕行急诊PCI组,其余通过急诊室送入冠心病监护病房或普通心脏病房然后再送入心导管室行急诊PCI者160例纳入对照组。比较两组病人症状发作至首次医疗接触时间(SO-to-FMC),首次医疗接触(FMC)至确诊时间(FMC-to-Dn),Dn至球囊扩张时间(Dn-to-B)。结果绕行急诊PCI组SO-to-FMC、Dn-to-B时间较对照组明显缩短,差异有统计学意义(P<0.05);两组FMC-to-Dn时间比较差异无统计学意义(P=0.973)。结论 SO-to-FMC时间短者更易接受急诊PCI,选择绕行急诊PCI者在Dn-to-B方面大大节约救治时间,对STEMI病人早期改善再灌注意义重大。
Objective To analyze the value of percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods A total of 232 STEMI patients undergoing emergency PCI within 12 hours from August 2011 to July 2015 were collected. Around the emergency room, coronary care unit or general cardiology ward directly into the catheterization room, 72 cases of emergency PCI into the bypass emergency PCI group, and the rest through the emergency room into the coronary care unit or general cardiology ward and then into Cardiac catheterization room emergency PCI in 160 cases were included in the control group. The symptoms of the two groups were compared between SO-to-FMC, FMC-to-Dn and Dn-to-B. Results Compared with the control group, the SO-to-FMC and Dn-to-B times in the bypass PCI group were significantly shorter than those in the control group (P <0.05). There was no significant difference in the FMC-to-Dn time between the two groups P = 0.973). Conclusions Shorter SO-to-FMC patients are more likely to receive emergency PCI. Choosing to bypass emergency PCI patients saves much time on Dn-to-B and is of great significance to early reperfusion in STEMI patients.