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目的探讨市级基层医院开展急诊经皮冠状动脉介入术绿色通道的可行性、安全性和有效性。方法对怀疑急性心肌梗死病人分为绿色通道组和非绿色通道组进行治疗,比较两组梗死相关血管再灌注时间、经皮冠状动脉介入术成功率、病死率、30d主要心血管事件、血B型利钠肽及左心室射血分数等指标。结果绿色通道组梗死相关血管再灌注时间较非绿色通道组明显缩短,降低病死率、30d主要心血管事件发生率以及术后7dB型利钠肽,改善心功能,差异有统计学意义;但住院时间和围术期成功率差异无统计学意义。结论B型利钠肽可作为急性心肌梗死病人急诊经皮冠状动脉介入术后早期心功能的预测指标;基层医院开展急性心肌梗死绿色通道可有效和安全地开展治疗急性心肌梗死。
Objective To investigate the feasibility, safety and effectiveness of municipal percutaneous coronary intervention in municipal primary hospitals. Methods The patients with suspected AMI were divided into two groups: the green channel group and the non-green channel group. The infarct-related vascular reperfusion time, the success rate of percutaneous coronary intervention, mortality, major cardiovascular events at 30 days, blood B Type natriuretic peptide and left ventricular ejection fraction and other indicators. Results The infarct-related vascular reperfusion time in the green channel group was significantly shorter than that in the non-green channel group, reducing the mortality, the incidence of major cardiovascular events at 30 days and the postoperative 7dB-type natriuretic peptide, improving the cardiac function. The difference was statistically significant. However, Time and perioperative success rate difference was not statistically significant. Conclusion B-type natriuretic peptide can be used as a predictor of early cardiac function in patients with acute myocardial infarction after emergency percutaneous coronary intervention. The green channel of acute myocardial infarction in primary hospitals can effectively and safely treat acute myocardial infarction.