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目的探讨急救医疗系统对急性ST段抬高型心肌梗死患者预后的影响。方法选取自2011年7月至2015年10月收治的急性ST段抬高型心肌梗死(STEMI)患者319例,按不同转运方式分为急救医疗系统(EMS)转运组与非EMS转运组。比较两组发病呼叫-首次医疗接触(So-to-FMC)时间、首次医疗接触-球囊扩张(FMC-to-B)时间、发病呼叫-球囊扩张(So-to-B)时间、入门-球囊扩张(D-to-B)时间的差异,分析不同转运方式发病距离与这些时间的关系。结果 EMS组So-to-FMC时间、FMC-to-B时间、So-to-B时间分别为60 min、143 min、105 min,非EMS组分别为96 min、177 min、175 min,两组间比较,差异有统计学意义(P<0.05);EMS组与非EMS组D-to-B时间分别为107 min与106 min,两组间比较,差异无统计学意义(P>0.05)。EMS组So-to-FMC时间、FMC-to-B时间、So-to-B时间不随着发病距离的增加而延长(P>0.05),而非EMS组So-to-FMC时间、FMC-to-B时间、So-to-B时间均随着发病距离的增加而延长(P<0.05)。结论运用EMS转运患者不会因为发病距离的延长而增加急救时间,可有效缩短院前急救时间,进而缩短心肌缺血时间,改善患者预后。
Objective To investigate the effect of emergency medical system on the prognosis of patients with acute ST-segment elevation myocardial infarction. Methods A total of 319 acute ST-segment elevation myocardial infarction (STEMI) patients were recruited from July 2011 to October 2015. They were divided into two groups: EMS and non-EMS group. The two groups were compared for So-to-FMC time, FMC-to-B time, So-to-B time, getting started - D-to-B balloon dilatation (D-to-B) differences in time, the incidence of different transport modes and the relationship between these times. Results The So-to-FMC time, FMC-to-B time and So-to-B time in EMS group were 60 min, 143 min and 105 min respectively, while those in non-EMS group were 96 min, 177 min and 175 min (P <0.05). The D-to-B times of EMS group and non-EMS group were 107 min and 106 min, respectively. There was no significant difference between the two groups (P> 0.05). The So-to-FMC time, FMC-to-B time and So-to-B time in EMS group were not longer with the increase of distance (P> 0.05) B time, So-to-B time increased with the increase of distance (P <0.05). Conclusion EMS patients will not increase the emergency time because of the extended distance, which can shorten the pre-hospital emergency time, shorten the myocardial ischemia time and improve the prognosis.