中西医结合开展急性心肌梗死绿色通道近期临床疗效

目的 探讨中西医结合急性心肌梗死（AMI）“绿色通道”创建的近期临床疗效。方法 75例ST段抬高的AMI患者按开通“绿色通道”前后分为绿色通道组（42例）和非绿色通道组（33例），均给予急诊经皮冠状动脉介入治疗，术后中药以扶正为主，观察两组症状发作-进入医院急诊时间（symptom-onset-to-door，SOTD）、急诊室到会诊时间（door-to-consult，DTC）、急诊室到导管室时间（door-to-lab，DTL）、急诊室到球囊扩张时间（door-to-balloon，DTB）和住院时间、住院费用及术后1个月内的主要心脏不良事件（major adverse cardiac events，MACE）发生率的对比。结果 绿色通道组的DTC、DTL、DTB时间均低于非绿色通道组（P〈0.01）。两组的住院时间分别为7．40天和11、83天（P=0，004），住院费用分别为51384．75元和61040.67元（P=0．022）；随访1个月，绿色通道组未发生MACE事件，而非绿色通道组发生5例事件两组比较差异有显著性（P=0．032）。结论 中西医结合AMI“绿色通道”的开展能够降低住院时间、住院费用和不是事件发生率，近期临床疗效满意。

Short-term Clinical Effects of Integrative Chinese and Western Medical Treatment through "Green Track" in Treating Acute Myocardial Infarction

Objective To comparatively study the short-term clinical effects of integrative Chinese and Western medical treatment (ICWM) on acute myocardial infarction (AMI) through "Green Track". Methods In the 75 patients with AMI enrolled in the study, 42 were hospitalized after (regarding as Group A) and the other 33 hospitalized before the opening of "Green Track" (regarding as Group B). All of them received the same treatment including primary percutaneous coronary intervention (PCI) and followed with Chinese medicines mainly for strengthening vital-qi. The time of symptom-onset-to-door (SOTD), door-to-consult (DTC), door-to-lab (DTL) and door-to-balloon (DTB), the duration and expense of hospitalization, and the incidence of major adverse cardiac events (MACE) occurred in one month after PCI between the two groups were compared. Results DTC, DTL and DTB in Group A were shorter than those in Group B respectively (P <0.01). The duration of hospitalization was 7.40 days in group A and 11.83 days in group B, and the expense was RMB 51 384.75 yuan in group A and RMB 61 040.67 yuan in group B, showing a significant difference between groups (P = 0.004, P = 0.022); during the one-month follow-up, no MACE occurred in group A but 5 cases (15%) occurred in group B, with significant difference between them (P= 0.032). Conclusion Tin-opening of "Green Track" and ICWM treatment displays a satisfactory short-term clinical effect on AMI, it could reduce the duration and expense of hospitalization and decrease the incidence of MACE occurred after PCI.