Mohammed Osama, Paramba Firjith C, Aboobaker Naushad V, Mohammed Riyadh A, Purayil Nishan K, Jassim Haitham M, Shariff Mohammad K, Aslam Saud M, Muhsen Farook F, Al Noor Khalid H, Al Kilani Hani H
Department of Emergency Medicine, Al Khor Hospital, Hamad Medical Corporation, P.O. Box 21086, Doha, Qatar.
Emerg Med Int. 2013;2013:208271. doi: 10.1155/2013/208271. Epub 2013 Sep 24.
Objective. Early restoration of coronary perfusion by thrombolysis or percutaneous coronary intervention is the main modality of treatment to salvage the ischemic myocardium. The earlier the procedure is completed, the greater the benefit is in saving myocardium and restoring its functions. The aim of the study is to compare the door-to-needle time (DNT) in acute ST elevation myocardial infarction (STEMI) in the period prior to December 2008 when the site of thrombolysis was in coronary care unit (CCU) and the period after that when the site was shifted to emergency department (ED). Methods. A retrospective, descriptive study was conducted at Al Khor Hospital, Qatar, in patients with acute STEMI who underwent thrombolysis at CCU and ED from April 2005 until December 2011, to compare the DNT, duration of hospitalization, and mortality. Results. A total of 211 patients with acute STEMI were eligible for thrombolysis; 58 patients were thrombolysed in the CCU and 153 in ED. The median DNT was reduced from 33.5 minutes in the CCU to 17 minutes in the ED representing a reduction of more than 50% with a P value of < 0.0001. Conclusion. The transfer of the thrombolysis site from CCU to the ED was associated with a dramatic and significant reduction in median door-to-needle time by more than half.
目的。通过溶栓或经皮冠状动脉介入治疗早期恢复冠状动脉灌注是挽救缺血心肌的主要治疗方式。手术完成得越早，在挽救心肌及其功能方面的获益就越大。本研究的目的是比较2008年12月之前溶栓地点在冠心病监护病房（CCU）时与之后溶栓地点转移至急诊科（ED）时急性ST段抬高型心肌梗死（STEMI）患者的门到针时间（DNT）。方法。在卡塔尔的阿尔霍尔医院对2005年4月至2011年12月期间在CCU和ED接受溶栓治疗的急性STEMI患者进行了一项回顾性描述性研究，以比较DNT、住院时间和死亡率。结果。共有211例急性STEMI患者符合溶栓条件；58例在CCU接受溶栓治疗，153例在ED接受溶栓治疗。中位DNT从CCU的33.5分钟降至ED的17分钟，降幅超过50%，P值<0.0001。结论。溶栓地点从CCU转移至ED与中位门到针时间显著大幅缩短一半以上相关。
