论文部分内容阅读
目的：探讨临床路径在急性 ST 段抬高心肌梗死（STEMI）急诊静脉溶栓治疗中的应用与效果。方法将2008年1月~2012年12月佛山市三家医院收治的STEMI急诊静脉溶栓治疗患者89例，分为临床路径组（CP组）41例和对照组48例，CP组入院后执行STEMI临床路径，对照组采用STEMI常规溶栓治疗与急救措施。比较两组患者入院10 min内首份ECG完成数、入门溶栓时间、溶栓后IRA再通率及不良反应和并发症的发生率。结果入院10 min内首份ECG完成数CP组较对照组相比增加27.39%，差异有统计学意义（P <0.05）。入门溶栓时间CP组较对照组平均缩短13 min ，差异有统计学意义（P <0.05）。溶栓后IRA再通率CP组较对照组提高18.7%，差异有统计学意义（P <0.05）。不良反应和并发症发生率CP组较对照组降低30.43%，差异有统计学意义（P <0.05）。结论在STEMI患者静脉溶栓治疗中应用临床路径可更快完成首份ECG检查，缩短患者入门溶栓时间，提高溶栓后IRA再通率，降低不良反应与并发症发生率，提高STEMI静脉溶栓治疗效果。“,”Objective To evaluate the effect of clinical pathway (CP) in thrombolytic therapy for patients with acute ST-segment elevation myocardial infarction (STEMI) in emergency departments. Methods A retrospective study was conducted on a total of 89 STEMI patients who received treatment in our department in between January 2008 and December 2012. The patients were divided into two groups, clinical pathway group of 41 (CP group), and control group of 48 which was given thromboclasis drug and other routine treatment. ECGs completed within 10 minutes, door-to-needle time, recanalization rate, adverse reactions and complications were compared between the two groups. Results ECGs completed within 10 minutes markedly increased by 27.39%(P <0.05), whereas the door-to-needle time was significantly shorter (median, 32.93 min vs.46.04min (P <0.05), in patients with STEMI than those in controls. it reflected a higher recanalization rate (85.37% vs. 66.67%(P <0.05),and lower rates of adverse reactions and complications (34.15% vs.64.58%(P <0.05),with CP group. Conclusion Clinical pathway is considered being effective in speeding up ECG, shortening door-to-needle time, increasing recanalization rate, simultaneously, reducing adverse reactions and complications and improving the outcome of thrombolytic therapy in patients with STEMI.