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目的:总结影响急性心肌梗死(AMI)患者接受急诊经皮冠状动脉介入术(PCI)治疗的主要原因,从而完善我们的医疗行为。方法:回顾性分析我院2006-01至2007-12所有急性ST段抬高的心肌梗死(STEMI)的临床资料、治疗方法及其影响因素;并将我院急诊PCI的各项数据与北京朝阳医院单中心急诊PCI结果进行对比。结果:在275例STEMI患者中,仅83例接受了急诊PCI术,其中男性71例,女性12例;选择静脉溶栓治疗者91例,其中男性59例,女性32例;超过再灌注治疗时机者63例;外院转入、有溶栓禁忌症、合并急性左心衰、心源性休克等严重并发症者38例。结论:目前影响基层患者接受急诊PCI的主要原因,可能包括;1、就医速度延迟;2、患者及家属的医疗素质较低,对手术的认知度低;3、女性受重视程度低;4、基层设备的不完善。随着全民医保的逐步健全,经济原因已不成为主要因素了;5、就医绿色通道不够通畅。
OBJECTIVE: To summarize the main causes of acute percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) and to improve our medical practice. Methods: The clinical data, treatment and influencing factors of all acute ST-segment elevation myocardial infarction (STEMI) in our hospital from January 2006 to December 2007 were analyzed retrospectively. The data of emergency PCI in our hospital were compared with Beijing Chaoyang Hospital single center emergency PCI results were compared. RESULTS: Of the 275 STEMI patients, only 83 received emergency PCI, 71 of them were men and 12 were women. Thirty-nine patients were selected for intravenous thrombolysis, including 59 males and 32 females, and surpassed the timing of reperfusion therapy In 63 cases, there were 38 cases with severe complications such as thrombolytic contraindications, acute left heart failure and cardiogenic shock. Conclusions: The main reasons for the current emergency PCI for primary patients may include: 1, delayed medical treatment; 2, lower medical quality of patients and their families, low awareness of surgery; 3, low priority for women; 4 , Imperfect grassroots equipment. With the gradual improvement of universal health insurance, economic reasons have not become a major factor; 5, medical green channel is not smooth enough.