Senges J, Schiele R
Herzzentrum, Klinikum Ludwigshafen, Bremserstrasse 79, 67063 Ludwigshafen, Germany.
Z Kardiol. 2004;93 Suppl 1:I16-8. doi: 10.1007/s00392-004-1106-9.
Patients with acute myocardial infarction reaching the hospital within the first hour after symptom onset preserve their chances for an optimal treatment. But only about one fifth of them actually reach the hospital within this "golden hour". Information of the public to reduce time from symptom onset to medical service call have shown success only during the time the continuous publicity was maintained. Soon after the end of such activities the prehospital delay again reached the initial duration. Because of restricted resources, prehospital thrombolysis as another means of reducing time to treatment is as yet only used for a very small proportion of patients. Reduction of door-to-balloon and -treatment time seems to have reached its limit in recent years. In patients with delayed hospital admission, the use of PTCA interventions seems to result in better outcome data compared to thrombolysis.
急性心肌梗死患者在症状发作后第一小时内到达医院，可获得最佳治疗机会。但实际上只有约五分之一的患者能在这个“黄金小时”内到达医院。向公众宣传以减少从症状发作到呼叫医疗服务的时间，仅在持续宣传期间取得了成功。此类活动结束后不久，院前延误时间又恢复到最初的时长。由于资源有限，作为另一种缩短治疗时间手段的院前溶栓目前仅用于极少数患者。近年来，缩短门球时间和治疗时间似乎已达到极限。对于延迟入院的患者，与溶栓相比，使用经皮冠状动脉腔内血管成形术（PTCA）干预似乎能产生更好的结果数据。
