Gokli A R, Kovar J L, Kowalenko T, Nowak R M
Department of Emergency Medicine, Henry Ford Hospital, Detroit, MI 48202.
Henry Ford Hosp Med J. 1991;39(3-4):170-5.
Each year more than 1 million people in the United States suffer from acute myocardial infarction (MI) with most of the deaths occurring within hours of symptom onset. Over the last 25 years, different prehospital systems have evolved throughout the world which allow early cardiac monitoring and treatment of acute MI patients. Thrombolytic therapy in acute MI has been shown to decrease mortality and preserve left ventricular function when administered early after onset of symptoms. The potential role of Emergency Medical Services or Mobile Coronary Care Units in achieving early thrombolysis is under investigation. Several studies of prehospital interventions to achieve early thrombolysis are reviewed. The use of thrombolytics by prehospital personnel has been found to be feasible, safe, and effective in reducing time delays. However, whether this translates into clinical benefit remains to be seen.
在美国，每年有超过100万人罹患急性心肌梗死（MI），其中大部分死亡发生在症状出现后的数小时内。在过去25年里，世界各地发展出了不同的院前急救系统，这些系统能够对急性心肌梗死患者进行早期心脏监测和治疗。急性心肌梗死的溶栓治疗已被证明，在症状出现后尽早给药可降低死亡率并保留左心室功能。紧急医疗服务或流动冠心病监护病房在实现早期溶栓方面的潜在作用正在研究中。本文综述了几项旨在实现早期溶栓的院前干预研究。已发现院前急救人员使用溶栓药物在减少时间延误方面是可行、安全且有效的。然而，这是否能转化为临床益处仍有待观察。
