急诊绿色通道在抢救急性心肌梗死患者中作用.docVIP

急诊绿色通道在抢救急性心肌梗死患者中作用[摘要]目的探讨急诊绿色通道在抢救急性心肌梗死( AMI)患者中的价值。方法回顾性分析自2003年设置急诊绿色通道以来,我科对124例AMI的诊断与治疗情况,观察其是否在有效的时间窗内得到治疗。结果124例患者中,在发病后2h内得到及时治疗29例,2～6h得到及时治疗者75例,6～12h得到及时治疗者16例,12h者4例,死亡7例。结论AMI患者在急诊绿色通道实施救治可减少心肌梗死患者在诊断、治疗 过程中时间的浪费,使之得到及时有效的救治。 [关键词] 急性心肌梗死;绿色通道 [中图分类号] R541 [文章标识码]A[文章编号] Effect of Emergency Green Track in Rescuing Patients With Acute Myocardial Infarction. Zhang Jianhua,Hao Yulan Peoples Hospital, Ningwu 036000, China. [Abstract] Objective To investigate the value of emergency green track in rescuing patients with acute myocardial infarction ( AMI).MethodsDiagnosis and treatment of 124 AMI patients were analyzed retrospectively since the green track was first put into practice for the last 3 years, and observed whether the patients were given treatment in operative time window.Results Among 124 patients, 29 cases were treated within 2 hours after the first episode occurred, 75 cases in 2 t0 6 hours and 16 cases in 6 t0 12 hours, 4 cases did not recive approprate treatment until 12 hours after the attack, seven patients died. ConclusionEmergency green track for AMI patient can effectively save the time for disease diagnosis and treatment, which is useful in rescuing patients with acute myocardial infarction. [Key words] Acute myocardial infarction; Emergency green track 急性心肌梗死( AMl)是一种严重危及人类生命健康的疾病,及时、准确地做出诊断并给予积极的治疗是降低急性期死亡率、改善长期预后的关键。近年来,AMI的治疗取得了令人瞩目的进展,治疗的“时间窗”对挽救濒死心肌具有重要意义。因此,在抢救过程中需要有一套别于其他急诊抢救的程序,以减少诊断、治疗过程中不必要的时间浪费。我科自2003年以来,结合我院的实际情况确定专门的AMI绿色通道,该通道24h开放,实施3年以来,共抢救了AMI 124例,现报道如下。 1资料与方法 1.1 一般资料收集2003年10月～2006年10月在我科确诊的AMI患者124例(男69例,女55例),年龄32～95岁,平均年龄64. 35岁。既往有冠心病史者76例,有高血压者65例,表现为心前区或胸骨后疼痛者103例,表现为急性左心功能不全者16例,出现心跳骤停者9例,出现各种室性心律失常、需要紧急处理者36例,心源性休克9例。 1.2 AMI诊断标准根据WHO的标准,心肌梗死的诊断必须具备下列3项中的2项:①胸痛或不适的临床表现;②连续的心电图演变;③心肌标记物浓度的动态改变。 1.3 AMI的治疗方法采用静脉溶栓或经皮冠状动脉内介入治疗( PCI)。 1.4急诊静脉内溶栓的适应证[1]①持续性胸痛大于0. 5h含服硝酸甘油症状不缓解;②相邻两个或多导联心电图ST段抬高,肢体导联大于0. 1mV、胸导联大于0.2mV;③发病≤6h者;④若患者来院已发病6～12h,心电图ST段抬高明显伴有或不伴有严重胸痛者仍可