JAMA子刊：STEMI患者无法及时行PCI 可选转院前溶栓治疗！

2014-12-18 高晓方译医学论坛网

美国一项研究表明，对于无法及时行直接经皮冠脉介入(pPCI)的患者，当及时再灌注治疗获益超过出血风险时，可选择医院转诊前行溶栓治疗并继之以血管造影。论文12月8日在线发表于《美国医学会杂志·内科学》(JAMA Intern Med)。此项研究确认了22481例适宜行pPCI或溶栓治疗且接受医院间转诊的ST段抬高型心肌梗死(STEMI)患者，并在上述患者中评估了估计的医院间转诊时间与再关注策略的

美国一项研究表明，对于无法及时行直接经皮冠脉介入(pPCI)的患者，当及时再灌注治疗获益超过出血风险时，可选择医院转诊前行溶栓治疗并继之以血管造影。论文12月8日在线发表于《美国医学会杂志·内科学》(JAMA Intern Med)。

此项研究确认了22481例适宜行pPCI或溶栓治疗且接受医院间转诊的ST段抬高型心肌梗死(STEMI)患者，并在上述患者中评估了估计的医院间转诊时间与再关注策略的相关性。主要转归指标为院内死亡和大出血。

结果显示，中位估计医院间转诊时间为57分钟。当估计转诊时间超过30分钟时，仅有42.6%接受pPCI治疗的患者实现了“就诊-球囊扩张时间”在120分钟内完成。转诊时间超过60分钟的适宜患者仅有52.7%接受溶栓治疗。

在15437例估计转诊时间为30至120分钟且适宜行溶栓治疗或pPCI的患者中，34.3%接受转诊前溶栓治疗，中位就诊至溶栓时间为34分钟。

溶栓治疗后，患者转诊至STEMI治疗中心的中位时间为49分钟，其中97.1%的患者接受了随访血管造影。溶栓和pPCI治疗者的死亡率无显著差异，但前者出血风险较高。

原始出处：

Fibrinolysis Use Among Patients Requiring Interhospital Transfer for ST-Segment Elevation Myocardial Infarction CareA Report From the US National Cardiovascular Data Registry

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2015-05-30 mhzhuang@stu.e

#院前#

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2015-06-26 12498c32m68暂无昵称

#STEMI患者#

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2014-12-22 2012GMxl

溶栓出血风险高

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2014-12-22 2012GMxl

溶栓出血风险高

130 0
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2014-12-20 lqvr

#溶栓治疗#

61 0
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2014-12-20 12498bb3m92(暂无昵称)

#STEM#

53 0

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JAMA子刊：STEMI患者无法及时行PCI 可选转院前溶栓治疗！

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