Ostricki Branko
Division of Cardiology, Department of Medicine, Cakovec County Hospital, Cakovec, Croatia.
Acta Med Croatica. 2009 Feb;63(1):39-41.
Primary percutaneous coronary intervention is the method of choice for reperfusion in the setting of acute coronary syndrome with ST elevation (STEMI). According to the guidelines, it is necessary to provide as many patients as possible with the opportunity of interventional treatment, even those living far from PCI capable hospitals. Every region in Croatia should develop a clear protocol for patients with acute coronary syndrome in whom primary PCI is indicated, while relying on already existing networks of healthcare providers. Therefore, the application of telemedical communication systems is useful, since it allows confirmation of the diagnosis by a specialist of internal medicine or cardiology and enables communication between physicians on the spot and physicians at a district hospital or PCI capable hospital. In order to save time, it should be attempted to transport the patient directly to the PCI capable hospital, skipping district hospital. The transport of the patient with the acute coronary syndrome is generally safe if safety protocols are followed: an educated attending healthcare professional, ambulance with required equipment and use of appropriate procedures of prehospital treatment.
直接经皮冠状动脉介入治疗是ST段抬高型急性冠状动脉综合征（STEMI）再灌注治疗的首选方法。根据指南，有必要为尽可能多的患者提供介入治疗机会，即使是那些居住在远离具备PCI治疗能力医院的患者。克罗地亚的每个地区都应制定明确的方案，以应对需要进行直接PCI治疗的急性冠状动脉综合征患者，同时依托现有的医疗服务网络。因此，远程医疗通信系统的应用很有用，因为它能让内科或心脏病学专家确认诊断，并使现场医生与地区医院或具备PCI治疗能力医院的医生之间进行沟通。为节省时间，应尝试将患者直接转运至具备PCI治疗能力的医院，跳过地区医院。如果遵循安全协议，急性冠状动脉综合征患者的转运通常是安全的：有经验的主治医护人员、配备所需设备的救护车以及采用适当的院前治疗程序。
