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目的探讨院前心电图对进行直接经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗的ST段抬高心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者进门至球囊扩张时间的影响。方法对2006年1月至2006年12月间就诊于北京安贞医院抢救中心进行直接PCI的STEMI患者的临床资料进行回顾性分析。根据是否有院前心电图将患者分为2组:心电图组和无心电图组。主要分析指标:进门至球囊扩张时间。次要分析指标:住院期间病死率。结果研究期间共入选147例患者,其中有院前心电图者92例(62.6%),进门至球囊扩张时间为(92±17)min;无院前心电图者55例(37.4%),进门至球囊扩张时间为(110±33)min,2组相比有统计学差异(P<0.01)。心电图组进门至球囊扩张时间<90min的患者显著多于无院前心电图组,分别为42%和23%(P<0.01)。有院前心电图者中以抢救车就诊的患者比例显著高于无心电图者,2组分别为95%和3%(P<0.01)。2组患者住院期间病死率无统计学差异(P>0.05)。结论院前心电图可以显著缩短ST段抬高心肌梗死患者进门至球囊时间,但目前院前心电图完成率较低,有待进一步改善。
Objective To investigate the effect of prehospital electrocardiogram (ECG) on the time from entry to balloon dilation in patients with ST-segment elevation myocardial infarction (STEMI) undergoing direct percutaneous coronary intervention (PCI). Methods A retrospective analysis was performed on the clinical data of STEMI patients who received direct PCI at the Rescue Center of Beijing Anzhen Hospital from January 2006 to December 2006. Patients were divided into 2 groups based on whether pre-hospital electrocardiogram was present: ECG group and ECG-free group. The main analysis indicators: from the door to the balloon dilation time. Secondary Analysis Indicators: Mortality during hospitalization. Results A total of 147 patients were enrolled during the study, 92 (62.6%) with prehospital electrocardiography and 92 ± 17 (min) entry to balloon and 55 (37.4%) with no prenuptial electrocardiography The time of balloon dilatation was (110 ± 33) min, there was significant difference between the two groups (P <0.01). There were significantly more patients in the electrocardiogram group than those without the prehospital electrocardiogram, which were 42% and 23%, respectively (P <0.01). The proportion of patients with ambulances in pre-hospital electrocardiographs was significantly higher than those without electrocardiogram (95% vs 3%, respectively) (P <0.01). There was no significant difference in mortality rate between the two groups during hospitalization (P> 0.05). Conclusion Prehospital electrocardiogram can significantly shorten the time from entry to balloon in patients with ST-segment elevation myocardial infarction. However, the rate of completion of pre-hospital electrocardiogram is still low and needs to be further improved.