确定急性心肌梗死治疗中院前溶栓的障碍。
Identifying barriers to prehospital thrombolysis in the treatment of acute myocardial infarction.
作者信息
Hanson T C, Williamson D
机构信息
Bristol University Medical School, Bristol, UK.
出版信息
Emerg Med J. 2006 Aug;23(8):650-3. doi: 10.1136/emj.2005.033993.
BACKGROUND AND OBJECTIVES
After an acute myocardial infarction (AMI) prehospital thrombolysis (PHT) reduces mortality compared with inhospital thrombolysis. In practice, a relatively small proportion of the total population with AMI receives PHT. This study was designed to identify the current barriers to PHT.
METHODS
A retrospective practice review of 57 consecutive patients treated in or before arrival at a district general hospital emergency department. All patients received thrombolysis for an AMI.
RESULTS
The main barriers to delivery of PHT appear to be the inclusion and exclusion criteria laid out in the ambulance service central guidelines. Despite recent widening of the inclusion criteria, 54% of patients eligible for immediate treatment on arrival in hospital either received or were eligible for PHT.
CONCLUSION
To increase the number of patients who are eligible for PHT these guidelines need to be revised further in line with inhospital criteria for thrombolysis.
背景与目的
与院内溶栓相比，急性心肌梗死（AMI）患者进行院前溶栓（PHT）可降低死亡率。在实际操作中，AMI患者总体中接受PHT的比例相对较小。本研究旨在确定当前PHT的障碍。
方法
对一家地区综合医院急诊科在到达前或到达时治疗的57例连续患者进行回顾性实践审查。所有患者均接受了AMI溶栓治疗。
结果
PHT实施的主要障碍似乎是救护服务中心指南中规定的纳入和排除标准。尽管最近纳入标准有所放宽，但54%在入院时符合立即治疗条件的患者接受了PHT或有资格接受PHT。
结论
为了增加有资格接受PHT的患者数量，这些指南需要根据院内溶栓标准进一步修订。
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