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目的:分析急性心肌梗死(acute myocardial infarction,AMI)院前延误时间分布及心肌梗死后不同时间段的预后情况。方法:选取AMI患者共208例,分析不同院前延误时间(pre-hospital delay times,PDT)患者的治疗情况、心室纤颤发生率、复苏成功率和死亡率。采用Logistic回归分析,分析影响PDT的相关因素。结果:61 min-120 min溶栓治疗率最高,为87.04%;121 min-240 min PCI/CABG治疗率最高,为20.93%;>720min药物治疗率最高,为100%,但无显著差异(P>0.05)。其中药物治疗组的PDT为(323.86±23.07)min,显著高于PCI/CABG组(108.69±10.84)min和溶栓组(112.35±15.73)min,(P<0.05)。首诊医院、处理方式、感知严重性、夜间发病和PDT具有显著相关性(P<0.05)。PDT≤120min组的心室纤颤发生率为12.26%,显著高于PDT>12 min组(P<0.05)。结论:患者和家属应加强学习AMI相关知识,缩短PDT,尽早诊治,避免因心室纤颤导致的死亡。
Objective: To analyze the distribution of pre-hospital delay of acute myocardial infarction (AMI) and the prognosis of different stages after myocardial infarction. Methods: A total of 208 patients with AMI were selected to analyze the treatment, ventricular fibrillation, resuscitation success rate and mortality in patients with different pre-hospital delay times (PDT). Logistic regression analysis was used to analyze the related factors affecting PDT. Results: The rate of thrombolysis was the highest at 61 min-120 min (87.04%). The rate of PCI / CABG at 121 min-240 min was the highest (20.93%), and the rate of drug treatment at 720 min was 100% > 0.05). The PDT was (323.86 ± 23.07) min in the drug-treated group, which was significantly higher than that in the PCI / CABG group (108.69 ± 10.84) min and in the thrombolytic group (112.35 ± 15.73) min (P <0.05). The first hospital, treatment, severity of seizure, nighttime onset and PDT had a significant correlation (P <0.05). The incidence of ventricular fibrillation was 12.26% in PDT≤120min group, which was significantly higher than that in PDT> 12min group (P <0.05). Conclusion: Patients and their families should learn more about AMI, shorten PDT, diagnose and treat as soon as possible, and avoid death caused by ventricular fibrillation.