区域协同救治系统的发展与模式的建立-中华灾害救援医学.PDF

中华灾害救援医学 2016 年 3 月 第 4 卷 第 3 期 Chinese Journal of Disaster Medicine, Vol.4, No.3, March, 2016 165 • 综 述 | REVIEWS • 区域协同救治系统的发展与模式的建立 1 2 综述 1 审校 刘晓曦 ，於四军 刘惠亮 【摘要 】 急性 ST 段抬高型心肌梗死（ST-segment elevation myocardial infarction，STEMI）病死率极高，及时准确的诊断和积 极的直接经皮冠状动脉介入治疗（percutaneous transluminal coronary intervention，PCI）是降低急性期患者病死率、改善其长期预 后的关键。笔者从 STEMI 患者救治流程引入，详细阐述急性心肌梗死（acute myocardial infarction，AMI）救治流程的建立、发展， 系统总结目前救治流程的现状、不足与困难，讨论 2013 年美国心脏协会（American Heart Association, AHA）STEMI 治疗指南（以 下简称《指南》）提出的救治要求，并探讨了新的救治流程——区域协同救治系统对救治流程、首次医疗接触至再灌注（器械） 时间（first medical contact to device time, FMC-D time）的影响。 【关键词 】 区域协同救治系统；ST 段抬高型心肌梗死；救治流程 【中国图书分类号 】 R54；R197 Development and model establishment of regional cooperative rescue system 1 2 1 LIU Xiaoxi , YU Sijun , and LIU Huiliang . 1. Clinical College of General Hospital of Chinese People’s Armed Police Forces, Anhui Medical University, Beijing 100039, China; 2. Department of Cardiology, General Hospital of Chinese People’s Armed Police Forces, Beijing 100039, China Corresponding author: LIU Huiliang, E-mail: lhl518@ Abstract 【 】 The mortality rate of acute ST-segment elevation myocardial infarction (STEMI) is very high, timely and accurate diagnosis and actively percutaneous transluminal coronary intervention (PCI) treatment are the key to reduce the mortality rate of patients in acute stage and improve their long-term prognosis. From the angle of STEMI patients’ treatment process, the author elaborated the establishment and development of treatment process for patients with acute myocardial infarction (AMI), systematically summarized the situation, deficiency and difficulty of current treatment process, discussed treatment requirements of the 2013 American Heart Association (AHA) guideline for the management of STEMI, and explored th