More R, Moore K, Quinn E, Perez Avila C, Davidson C, Vincent R, Chamberlain D
Department of Cardiology, Royal Sussex County Hospital, Brighton, UK.
Int J Cardiol. 1995 Aug;49 Suppl:S39-46. doi: 10.1016/0167-5273(95)02338-w.
We reviewed the effectiveness of a strategy involving paramedic ambulances and community education to reduce the delay to thrombolytic therapy in patients admitted with acute myocardial infarction, by analysing delay times recorded during routine treatment. Rapid identification and treatment of patients with acute myocardial infarction who were eligible for thrombolysis was carried out in the Accident and Emergency and Cardiac Care Units. Two hundred seventy-four patients were admitted with acute myocardial infarction over an 18-month period and treated with anistreplase (168) or streptokinase (106). The following median times were recorded: symptom onset to administration of thrombolytic therapy, 142 min (range 43-980 min); symptom onset to ambulance arrival, 60 min; ambulance with patient to arrival in hospital, 35 min; time to treatment in hospital ('door to needle time'), 25 min; in-hospital delays were notably shorter for patients given anistreplase as opposed to streptokinase. Shortened delays for the delivery of thrombolytic therapy can be achieved by a strategy involving public education, the availability of resuscitation ambulances, and close liaison with the Accident and Emergency Department.
我们通过分析常规治疗期间记录的延迟时间，回顾了一项涉及护理人员救护车和社区教育的策略在减少急性心肌梗死患者溶栓治疗延迟方面的有效性。在急症室和心脏护理病房对符合溶栓条件的急性心肌梗死患者进行快速识别和治疗。在18个月的时间里，有274例急性心肌梗死患者入院，并接受了茴酰化纤溶酶原链激酶复合物（168例）或链激酶（106例）治疗。记录到的以下中位时间为：症状发作至溶栓治疗给药，142分钟（范围43 - 980分钟）；症状发作至救护车到达，60分钟；救护车搭载患者至抵达医院，35分钟；医院内治疗时间（“门到针时间”），25分钟；与接受链激酶治疗的患者相比，接受茴酰化纤溶酶原链激酶复合物治疗的患者在医院内的延迟明显更短。通过一项涉及公众教育、配备复苏救护车以及与急症室密切联络的策略，可以缩短溶栓治疗的延迟时间。
