影响急性ST段抬高心肌梗死患者转运延迟的因素研究被引量：7

Factors Related to Transportation Time in Patients with Acute ST Segment Elevation Myocardial Infarction

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摘要目的探讨影响急性ST段抬高的心肌梗死（STEMI）患者决定就医到转运至医院的时间的因素。方法2003年9月～2004年7月，连续住院（宣武和潞河医院）并确诊为STEMI的患者329例，根据决定就医后是否1h内到达指定医院分为两组：短转运组和长转运组。对比分析两组资料。结果有192（58.4％）例惠者决定就医后1h内到指定医院，仅有26.75％的患者应用急救医疗服务到院。单因素分析与转运时间有关的因素是：冷汗．症状能忍受，自费，转运距离，突然发作，症状进展，直接转运至指定医院，心肌梗死家族史，听说过心肌梗死，服用非硝酸酯类药物。多元Logistic回归分析表明冷汗，转运距离≤10km，直接转运至指定医院是预测转运时间短的因素，而症状能忍受和服用非硝酸酯类药物则是预测转运时间长的因素。结论基层医院转运延迟明显，应提高对STEMI的诊断和治疗的认识，发现STEMI患者应当及早转运并提倡急救车转运。 Objective To explore the factors related to transportation time in patients experiencing acute ST -segment elevation myocardial infarction （STEMI）. Methods 329 consective patients confirmed STEMI from Sep. 2003 to Jul. 2004 in Xuanwu and Luhe Hospital were divided into two groups based on the transportation time： short transportation time （ ≤ 1 hour） group and long transportation time （〉 1 hour） group. A questionnaire developed to assess demographic characteristics, clinical factors and psychological factors. Patients were interviewed within 72 hours of admission to 2 hospitals. Results 192 patients were transferred to the study hospital within 1 hour after call for medical help, only 26. 75% patients with STEMI used emergency medical service （EMS）. Factors associated with transportation time in a univariate analysis were cold sweat, bearable symptoms, cost by oneself, distance from the site of symptom onset to the study hospital, sudden onset, progressive symptoms, directly transferred to hospital, family history of heart attack, known myocardial infarction as a fatal disease, taking non - antinitrate. In a multivariate analysis, cold sweat, distance ≤ 10km, directly transferred to hospital appeared as predictors of short transportation time and bearable symptoms and taking non - antinitrate for long transportation time. Conclusion Grass - roots hospitals play an important role in transportation time to hospital, it＇s important to improve the diagnostic level of STEMI and knowledge of treatment and transferred the patients with STEMI to hospital especially by EMS as soon as possible.

作者郭金成华琦刘东霞陈海翎许骥温宇梅

机构地区首都医科大学宣武医院心内科北京市通州区潞河医院心内科

出处《中国全科医学》 CAS CSCD 2006年第4期307-308,共2页 Chinese General Practice

关键词心肌梗死急性急诊医疗服务转运 Acute myocardial infarction Emergency medical service Transportation

分类号 R542.22 [医药卫生—心血管疾病]

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