论文部分内容阅读
目的：对急诊科急性心肌梗死（ＡＭＩ）急诊溶栓治疗适应证与中华心血管病杂志编委会拟定的ＡＭＩ溶栓疗法参考方案（溶栓疗法参考方案）适应证正确符合率进行比较，分析未接受溶栓治疗的原因，探讨扩大急诊溶栓治疗的适应证。方法：收集１９９５年２月～１９９７年２月急诊科收治的确诊ＡＭＩ患者资料，根据溶栓疗法参考方案，分析临床决策符合率。结果：共收集２００例符合ＡＭＩ诊断标准的患者的总溶栓率为２４．０％（４８／２００），溶栓正确符合率为１００．０％，非溶栓正确符合率为７７．０％。未接受溶栓的原因主要是因为患者来诊时间在发病后１２小时以上，年龄超过７０岁及非Ｑ波心肌梗死患者。结论：急诊科溶栓具有良好的正确符合率，但溶栓条件选择较严，使较多适宜溶栓治疗的患者未得到溶栓治疗。今后仍应加强对来诊时在发病后１２小时以内、年龄７０岁以上及非Ｑ波心肌梗死患者的溶栓研究。
OBJECTIVE: To compare and analyze the correct coincidence rate of indications of AMI thrombolytic therapy and AMI thrombolysis reference protocol (thrombolytic therapy reference program) prepared by the Editorial Board of Chinese Cardiovascular Diseases The reasons for not receiving thrombolytic therapy, to explore the expansion of emergency indications of thrombolytic therapy. Methods: The data of patients with confirmed AMI who were admitted to the emergency department from February 1995 to February 1997 were collected. According to the reference scheme of thrombolytic therapy, the coincidence rate of clinical decision was analyzed. Results: A total of 200 cases of patients with AMI diagnostic criteria for the total thrombolysis rate was 24.0% (48/200), the correct coincidence rate of thrombolysis was 100.0%, the correct coincidence rate of non-thrombolysis was 77.0% . The reason for not receiving thrombolysis is mainly because patients came to the consultation time more than 12 hours after onset, over the age of 70 and non-Q wave myocardial infarction patients. Conclusion: The emergency department thrombolysis has a good correct coincidence rate, but the thrombolytic conditions are more stringent, so that more thrombolytic therapy patients without thrombolytic therapy. In the future, the thrombolytic study should be strengthened in patients who are diagnosed within 12 hours after onset, over the age of 70 and in patients with non-Q wave myocardial infarction.