Murphy A W, Power R, Ungruh K, Bury G
Department of General Practice Professional Unit, University College, Dublin.
Ir J Med Sci. 1992 Oct;161(10):593-6. doi: 10.1007/BF02942365.
Two-hundred and eleven Irish GPs responded to a questionnaire survey of their experience and management of acute myocardial infarction (MI) and their attitudes to the use of thrombolytic therapy Three-quarters of the respondents felt they dealt with three or more MIs per year; most felt that the majority of MIs were initially seen by a GP. Diagnosis is based on clinical findings; only 11% routinely take an ECG. Management is largely oriented to relief of pain but intravenous narcotics are only used by a minority. Hospital referral for suspected acute MI was the preferred choice for almost all GPs in a variety of patient-care scenarios. Home care for MI was chosen only for a minority of elderly patients when some hours had elapsed since the onset of symptoms. Definitive guidelines on the pre-hospital use of thrombolysis are not yet available. However, eighty per cent of respondents in this study feel that thrombolysis is beneficial and many feel that it has value in the pre-hospital situation. Respondents identified educational, organisational and financial problems to be overcome before this could happen.
211名爱尔兰全科医生回复了一份关于他们对急性心肌梗死（MI）的治疗经验及管理情况，以及他们对使用溶栓疗法态度的问卷调查。四分之三的受访者表示他们每年要处理三例或更多的心肌梗死病例；大多数人认为大多数心肌梗死患者最初是由全科医生接诊的。诊断基于临床症状；只有11%的人会常规进行心电图检查。治疗主要是为了缓解疼痛，但只有少数人使用静脉麻醉剂。在各种患者护理场景中，几乎所有全科医生都首选将疑似急性心肌梗死患者转诊至医院。只有少数老年患者在症状出现数小时后才会选择居家护理心肌梗死患者。目前尚无关于院前使用溶栓疗法的明确指南。然而，本研究中80%的受访者认为溶栓疗法是有益的，许多人觉得它在院前情况下有价值。受访者指出，在这能够实现之前，还有教育、组织和资金方面的问题需要克服。
