中国动脉硬化杂志2012，Vol.20Issue(6)：545-548,4.
临床路径对ST段抬高心肌梗死患者再灌注治疗疗效的影响
Impact of Clinical Pathways on the Curative Effect of Myocardial Reperfusion in Patients with ST-segment Elevation Myocardial Infraction
摘要
Abstract
Aim To evaluate the effect of clinical pathways on door-to-balloon ( D2B) time, the curative effect of myocardial reperfusion in patients with ST-segment elevation myocardial infarction (STEMI). Methods 100 patients treated with STEMI emergency percutaneous coronary intervention (PCI) clinical pathways were chosen randomly as the experimental group while 100 un-treated patients were chosen as the control group. The primary observation indexes are: D2 B time, the number of cases achieving thrombolysis in myocardial infarction ( TIMI) 3 flow, lowering of ST segment 90 min after PCI, the time to peak aerum creatine kinase-mb (CK-MB) levels and in-hospital mortality rate. Results The D2B time of experimental group was significantly shorter than that of control group (Median, 65 min vs 95 min, P < 0.001), and the number of patients receiving primary PCI within the guideline-recommended 90 min was greater in the experimental group than in the control group (98% vs 65% , P <0. 001). More patients achieved TIMI 3 flow (94% vs 81 % , P < 0. 05) and lowering of ST segment 90 min after PCI ( 88% vs 67% , P < 0.05) than those in control group. Time to peak serum CK-MB levels was evidently improved (7. 8 ±0.5 vs 10. 1 ±0.4, P <0.05) and in-hospital mortality rate of the experimental group was significantly less than the control group (2% vs 7% , P <0.001). Conclusions Clinical pathways were associated with a significantly shorter D2B time, the increase of the proportion of patients undergoing primary PCI within 90 min of hospital arrival. It could also help to significantly improve the myocardial microcirculation of the infraction area, evidently promote the curative effect of myocardial reperfusion in acute myocardial infarction and reduce the in-hospital mortality rate.关键词
心肌梗死/临床路径/就诊至球囊扩张时间Key words
Myocardial Infarction/Clinical Pathways/Door-to-balloon Time分类
医药卫生引用本文复制引用
李忠红,王丽丽,刘强,曹倩,罗颖,田芳,耿庆山..临床路径对ST段抬高心肌梗死患者再灌注治疗疗效的影响[J].中国动脉硬化杂志,2012,20(6):545-548,4.基金项目
深圳市科技研究项目(201102181) （201102181）
