本文選題：胸痛中心 + 急性心肌梗死��； 參考：《福建中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：第一章胸痛中心模式對STEMI患者的影響目的:探討規(guī)范化胸痛中心急救模式對STEMI患者心肌總?cè)毖獣r(shí)間及預(yù)后的影響。方法:連續(xù)入組經(jīng)胸痛中心模式入院行急診PCI的STEMI患者96例,與胸痛中心成立前經(jīng)綠色通道入院行急診PCI的STEMI患者121例進(jìn)行比較,分為胸痛中心組與綠色通道組,收集患者臨床一般資料、相關(guān)時(shí)間指標(biāo)、冠脈造影資料、術(shù)后隨訪資料等。結(jié)果:1、兩組患者D-to-B時(shí)間均明顯縮短,特別是胸痛中心組,已達(dá)國際標(biāo)準(zhǔn)≤90min。胸痛中心組FMC-to-B時(shí)間、總?cè)毖獣r(shí)間亦較綠色通道組改善,且均有統(tǒng)計(jì)學(xué)意義(P0.05)。2、胸痛中心組D-to-B時(shí)間、FMC-to-B時(shí)間達(dá)標(biāo)率均明顯高于綠色通道組。3、二分類 Logistic 回歸分析顯示,外院轉(zhuǎn)入(OR=24.269,95%CI=11.101-53.058,P0.001)、高中及以上學(xué)歷(OR=2.484,95%CI=1.163-5.306,P=0.019)是影響 FMC-to-B時(shí)間達(dá)標(biāo)的獨(dú)立預(yù)測因素。4、對急性心衰、術(shù)后24h內(nèi)心絞痛、術(shù)后ST段回落50%、術(shù)中發(fā)生惡性再灌注心律失常及再灌注心律失常等差異有統(tǒng)計(jì)學(xué)意義(P均0.05);心源性死亡差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:1、胸痛中心模式可以縮短心肌總?cè)毖獣r(shí)間并提高D-to-B時(shí)間、FMC-to-B時(shí)間的達(dá)標(biāo)率;2、外院轉(zhuǎn)入及具有高中及以上學(xué)歷與FMC-to-B時(shí)間存在一定相關(guān)性,可能是影響FMC-to-B時(shí)間達(dá)標(biāo)的因素;3、胸痛中心模式能在一定程度上改善STEMI患者的預(yù)后。第二章胸痛中心模式聯(lián)合麝香保心丸治療對STEMI患者的影響目的:了解經(jīng)胸痛中心模式入院行急診PCI的STEMI患者術(shù)后聯(lián)合麝香保心丸治療是否能帶來進(jìn)一步的臨床獲益。方法:將96例胸痛中心組患者采用隨機(jī)分組法分為麝香保心丸組和常規(guī)藥物組,兩組均予冠心病二級(jí)預(yù)防藥物,麝香保心丸組加用麝香保心丸(2粒,3/日),共隨訪3個(gè)月,觀察心功能分級(jí)、心絞痛分級(jí)、BNP及CRP指標(biāo)。結(jié)果:麝香保心丸組與常規(guī)藥物組心絞痛癥狀均有改善,兩組心絞痛分級(jí)差異有統(tǒng)計(jì)學(xué)意義(P=0.0360.05),對心功能、BNP、CRP 無影響(P0.05)。結(jié)論:經(jīng)胸痛中心模式入院行急診PCI的STEMI患者術(shù)后聯(lián)合麝香保心丸能夠改善患者心絞痛癥狀。
[Abstract]:Chapter 1 the effect of chest pain Center Model on STEMI patients objective: to explore the effect of standardized chest pain center emergency mode on myocardial ischemia time and prognosis in patients with STEMI. Methods: 96 STEMI patients who were admitted to emergency PCI through chest pain center were compared with 121 STEMI patients who were admitted through green channel before the establishment of chest pain center. They were divided into chest pain center group and green channel group. Collect the general clinical data, relevant time index, coronary angiography data, postoperative follow-up data and so on. Results the D-to-B time of the two groups was significantly shorter than that of the control group, especially in the central group of chest pain, which had reached the international standard of 鈮，

本文編號(hào)：1951970