Value of "Bian Que Flying Rescue" system for acute myocardial infarction patients with ST-segment elevation
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摘要: 目的 通过对比"扁鹊飞救"系统应用前后急性ST段抬高型心肌梗死(STEMI)患者救治延迟及临床预后的改善情况,明确该系统在STEMI救治中的意义。 方法 纳入2015年1月-2016年1月运用"扁鹊飞救"系统转运至无锡市第二人民医院就诊的STEMI患者70例为扁鹊飞救组,之前未使用该系统转运的70例STEMI患者作为对照组。受试者在院均接受急诊PCI治疗。通过转运及院内急救系统收集2组患者"首次医疗接触至球囊扩张(FMC2B)"时间、"门-球(D2B)"时间,记录患者住院天数、左心室射血分数(LVEF),出院后随访6个月内临床预后。 结果 与对照组相比,扁鹊飞救组FMC2B时间及D2B时间缩短,同时FMC2B时间及D2B时间达标率较高,住院天数显著降低,左心室射血分数(LVEF)显著升高;Kaplan-Meier生存分析发现扁鹊飞救组患者无事件生存率显著高于对照组,Logistic回归分析见FMC2B时间>120 min及D2B时间>90 min是MACE的独立危险因素,其优势比(OR值、95% CI)分别为2.637(0.754~9.326)和1.013(0.985~1.033);差异均有统计学意义。 结论 "扁鹊飞救"系统缩短STEMI救治延迟,可改善患者临床预后。
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关键词:
- “扁鹊飞救”系统 /
- ST段抬高型心肌梗死 /
- 首次医疗接触至球囊扩张时间 /
- 门-球时间 /
- 预后
Abstract: Objective To observe the value of "Bian Que Flying Rescue" system for acute ST segment elevation myocardial infarction (STEMI) patients by observing change of myocardial reperfusion time and prognosis with this system. Methods Total 70 STEMI patients who were transported to Wuxi Second People's Hospital by "Bian Que Flying Rescue" system between January, 2015 to January, 2016 were selected as Bian Que Flying Rescue Group, meanwhile, 70 STEMI patients who were transported before the system operating assigned into Control Group. All of patients were accepted emergency PCI. Features like first medical contact to balloon (FMC2B) time, door to balloon (D2B) time, average hospitalization days, and LVEF were collected. All patients were followed up for 6 months to observe the prognosis. Results Compared with Control Group, FMC2B time and D2B time were significantly shorter and attainment rates were higher, a downward trend had shown in hospitalization days and LVEF was improved in Bian Que Flying Rescue Group, and Kaplan-Meier survival analysis found that the non-MACE survival rate was significantly higher in Bian Que Flying Rescue group than control group, Logistic regression analysis revealed that FMC2B time>120 min and D2B time>90 min were independent risk factor for MACE, the odds ratio (OR) (95% CI) were 2.64 (0.75-9.33) and 1.01 (0.99-1.03); all of P value were less than 0.05. Conclusion "Bian Que Flying Rescue" system can significantly cut down the treatment delay, improve clinical prognosis for the patients with STEMI.
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