急救医疗系统对急性ST段抬高型心肌梗死患者预后影响

目的探讨急救医疗系统对急性ST段抬高型心肌梗死患者预后的影响。方法选取自2011年7月至2015年10月收治的急性ST段抬高型心肌梗死(STEMI)患者319例,按不同转运方式分为急救医疗系统(EMS)转运组与非EMS转运组。比较两组发病呼叫-首次医疗接触(So-to-FMC)时间、首次医疗接触-球囊扩张(FMC-to-B)时间、发病呼叫-球囊扩张(So-to-B)时间、入门-球囊扩张(D-to-B)时间的差异,分析不同转运方式发病距离与这些时间的关系。结果 EMS组So-to-FMC时间、FMC-to-B时间、So-to-B时间分别为60 min、143 min、105 min,非EMS组分别为96 min、177 min、175 min,两组间比较,差异有统计学意义(P<0.05);EMS组与非EMS组D-to-B时间分别为107 min与106 min,两组间比较,差异无统计学意义(P>0.05)。EMS组So-to-FMC时间、FMC-to-B时间、So-to-B时间不随着发病距离的增加而延长(P>0.05),而非EMS组So-to-FMC时间、FMC-to-B时间、So-to-B时间均随着发病距离的增加而延长(P<0.05)。结论运用EMS转运患者不会因为发病距离的延长而增加急救时间,可有效缩短院前急救时间,进而缩短心肌缺血时间,改善患者预后。

Effects of the distances on pre-hospital time delay of patients with acute ST elevation myocardial infarction

Objective To investigate the effects of the different distances on pre-hospital time of patients with STEMI. Methods A retrospective study was perfromed on 319 patients with acute ST elevation myocardial infarction(STEMI)who were admitted from July 2011 to October 2015. Patients were divided into the EMS group and Non-EMS group according to the different route. To analyse the time intervals,including symptom onset-to-first medical contact(So-to-FMC)time,first medical contact-to-balloon(FMC-to-B)time, symptom onset call-to-balloon(So-to-B)and Door-to-balloon(D-to-B)time and relationship between distance and these time inter-vals. Results In the EMS group and Non-EMS group,the median So-to-FMC time,FMC-to-B time and So-to-B time were 60minutes versus 96minutes,143 minutes versus 177minutes and 105 minutes versus 175minutes,respectively(P < 0. 05). In the EMS group and Non-EMS group,D-to-B time was 107 minutes and 106 minutes,which had no statistically significant difference(P > 0. 05). In the EMS group,So-to-FMC time,FMC-to-B time and So-to-B time were not delayed with the increase of distances(P > 0. 05),while So-to-FMC time,FMC-to-B time and So-to-B time were delayed with the increase of distances in Non-EMS group (P < 0. 05 ). Conclusion Thetreatment time is not delayed with the different distances in patients with STEMI by using EMS. This shows that EMS is good for shortening the pre-hospital time delay,so to shorten the total ischemia time,and improve the prognosis of patients.