【摘要】 目的分析贵州省在新型冠状病毒肺炎(COVID-19)疫情期间ST段抬高型心肌梗死(STEMI)患者的救治特征,为疫情的防控、诊断、治疗及决策提供详实的数据基础与参考。方法选取2020年1月21日至2月24日贵州省内的13所三级甲等教学医院心内科收治的STEMI患者作为观察组,选取这13所医院2019年同期收治的STEMI患者作为对照组。记录所选对象的性别、年龄及慢性合并症情况。记录两组对象在各家医院的就诊数量、救治方式及并发症情况。记录患者的总缺血时间、发病-首次医疗接触、首次医疗接触-导丝通过及入门-导丝通过时间。结果 13所三甲医院中12所为胸痛中心标准版认证单位,13所均分属当地胸痛中心联盟并为教学医院。两组患者的性别、年龄、吸烟史及慢性病情况差异均无统计学意义。观察组溶栓患者数较对照组明显降低[17(5.96%)比30(14.63%),P<0.01],非溶栓及PCI患者较对照组明显升高[38(18.54%)比75(76.32%),P<0.05],溶栓成功患者、急诊PCI患者,心力衰竭与死亡患者数目两组均无差异。观察组总缺血时间、发病-首次医疗接触时间、首次医疗接触-导丝通过时间及入门-导丝通过时间均长于对照组[(452.32±88.75)min比(335.06±50.64)min、(360.05±97.28)min比(210.05±75.32)min、(180.57±58.66) min比(116.17±50.84) min、(7 1.35±26.38) min比(62.57±20.34) min,P均<0.0 1]。结论 COVID-19疫情使贵州省STEMI患者的发病就诊时间明显延长,表现为总缺血时间、发病-首次医疗接触、首次医疗接触-导丝通过及入门-导丝通过时间的延长,但对总体溶栓成功率、心力衰竭发生数量、死亡患者数没有明显影响。更多还原

【Abstract】 Objective To analyze the characteristics of the treatment of STEMI patients in Guizhou Province during the COVID-19 and provide a detailed data basis and reference for the prevention,control,diagnosis,treatment and decision-making for the epidemic.Methods The STEMI patients admitted to the cardiology department of 13 First class hospital s in Guizhou province from January 21 to February 24,2020 were selected as the experimental group.The STEMI patients admitted to the same hospital in the same period in 2019 as the control group.The sex,age and chronic comorbidities of the selected subjects were recorded.The number of treatments,treatment methods and complications of the two groups were recorded.The patient’s total ischemic time,onset-first medical contact,first medical contact-guide wire passage and entry-guide wire passage time were recorded.Results 13 First class hospitals in Guizhou Province were selected,12 of which were certified units of chest pain centers and all of them were all affiliated with the local chest pain center alliance and teaching hospitals.There were no statistical differences between the two groups in gende,age,smoking history and chronic disease.The number of thrombolytic patients in the experimental group was significantly lower than that in the control group [17(5.96%) vs.30(14.63%),P<0.01].Compared with the control group,non thrombolytic and PCI patients were significantly higher [38(18.54%) vs.75(76.32%),P<0.05].There was no difference between the two groups in patients with successful thrombolysis,emergency PCI patients,heart failure and death patients.The total ischemia time,onset-first medical contact time,first medical contact-guide wire passing time and entryguide wire passing time of the experimental group were all longer than those of the control group [(452.32±88.75)min vs.(335.06±50.64) min,(360.05±97.28)min vs.(210.05±75.32)min,(180.57±58.66)min vs.(116.17±50.84) min,(71.35±26.38) min vs.(62.57 ±20.34) min,all P<0.01].Conclusion The COVID-19 has significantly prolonged the time of treatment time for STEMI patients in Guizhou Province,manifesting as total ischemia time,onset-first medical contact,first medical contact-guide wire passage and entry-guide wire passage time extension.There was no significant effect on the overall thrombolytic success,heart failure occurrence and the number of death.更多还原