CAJ | 학술논문

目的探讨急性ST段抬高心肌梗死(STEMI)患者院前延迟时间分布及其影响因素.方法回顾性分析328例STEMI患者的一般资料,统计其院前延迟时间(PHD).并从溶栓成功的257例患者中随机抽取71例作为A组,溶栓失败的71例作为B组,分析其PHD常见和高危影响因素.结果⑴328例PHD为(158±46)min,其中1h内40.6%、2h内42.4%、6h内14.3%、6h以上2.7%;⑵常见因素中,A组中风或心绞痛史病情不明显,活动性胃肠道出血,相关慢性疾病,被动就诊,间接转运和转运耽误比率显著低于B组(P<0.05或P<0.01);⑶病情不明显,间接转运和转运耽误是导致PHD延长的高危因素(P<0.05或P<0.01).结论应加强心脏疾病相关常识的大众教育,同时完善相关的应急调控体系,确保患者能选择所需时间最短的路线,最快到达能对病情做出有效处理的医院.
목적탐토급성ST단태고심기경사(STEMI)환자원전연지시간분포급기영향인소.방법회고성분석328례STEMI환자적일반자료,통계기원전연지시간(PHD).병종용전성공적257례환자중수궤추취71례작위A조,용전실패적71례작위B조,분석기PHD상견화고위영향인소.결과⑴328례PHD위(158±46)min,기중1h내40.6%、2h내42.4%、6h내14.3%、6h이상2.7%;⑵상견인소중,A조중풍혹심교통사병정불명현,활동성위장도출혈,상관만성질병,피동취진,간접전운화전운탐오비솔현저저우B조(P<0.05혹P<0.01);⑶병정불명현,간접전운화전운탐오시도치PHD연장적고위인소(P<0.05혹P<0.01).결론응가강심장질병상관상식적대음교육,동시완선상관적응급조공체계,학보환자능선택소수시간최단적로선,최쾌도체능대병정주출유효처리적의원.
Objective To explore the time distribution and influencing factor of PHD for patients with STEMI. Methods The general information of 328 cases of patients with STEMI was analyzed,and the PHD was summarized.71 cases of patients that selected from 257 cases of thrombolytics successful patients were as group A, and 71 cases of thrombolytics failing patients were as group B, the common and risky influencing factor were analyzed. Results (1)The average time of all patients:(158±46) min.time distribution:in 1h:40.6%;in 2h:42.4%;in 6h:14.3%;above 6h:2.7%. (2)In common factors, history of apoplexy or angina, unconspicuous disease syndrome, active bleeding of gastrointestinal tract, related chronic disease, passive emergency treatment, indirect transport and transport delay in group A were significantly less than in group B (P<0.05 or P<0.01). (3)Unconspicuous disease syndrome, indirect transport and transport delay were risky factors that made PHD prolong. Conclusion It should strengthen public education about general knowledge of heart disease, and perfect regulatory system of emergency treatment at same time,to make sure the patients can choose route that needs shortest time,and arrive hospital that can provide effective aid as soon as possible.