RÚT NGẮN THỜI GIAN cửa BÓNG TRONG CAN THIỆP MẠCH VÀNH TIÊN PHÁT ở BỆNH NHÂN NHỒI máu cơ TIM cấp ST CHÊNH LỆCH tại BỆNH VIỆN NHÂN dân GIA ĐỊNH

RÚT NGN THI GIAN CA - BÓNG TRONG CAN THIP MCH VÀNH TIÊN PHÁT
 BNH NHÂN NHP ST CHÊNH LÊN
TI BNH VINH

Hoàng Quốc Hòa, Nguyễn Đỗ Anh
Bnh vinh


Mục tiêu: - -
- 
 
Đối tượng và phương pháp nghiên cứu: 

 03/2011.
Kết quả: - 
          
- II / III - IV: 88%: 12%, nhóm Killip IV (

                  


- -2011
 
 -  

Kết luận: - 


 - 


Từ khóa: 
-bóng.

SUMMARY
SHORTENING OF DOOR -TO - BALLOON TIME IN PRIMARY PERCUTANEOUS
CORONARY INTERVENTION IN PATIENTS WITH ST SEGMENT ELEVATION

Objectives: Access door-to-balloon time and its time intervals before (2009) and after
improving the strategies (2010  2011). Study of clinical features, electrocardiogram (ECG) on
admission, coronary culprit lesions
Methods and Materials: Observative, descriptive, and cross-sectional study of all STEMI
patients with a pre-hospital delay of up to 24 hours underwent PPCIs at Gia Dinh hospital from
April 2009 to March 2011.
Results: 293 STEMI patients have undergone PPCIs successfully at our hospital from April
2009 to March 2011. The top three risk factors are smoking (61.85%), hypertension (60.1%) and
dyslipidemia (38.2%). Killip class I - II / III - IV: 88%: 12%, Killip class IV subgroup (cardiogenic
shock) count for 10,6%. Risk stratification by TIMI score: 84% low and intermediat groups,16%
high risk group. Ratio between anterior and inferior wall myocardial infarction recorded by ECG is
approximately equal 51,5%: 46,3%. Distribution of culprit lesions: LM: 0,7%, LAD: 48,5%, RCA:
43% and LCx: 7,8%. Threre is increasing the percentage of PPCIs avchied door-to-balloon time
less 90 minutes: 52.6% in 2011 compared to 10.7% in 2009. This percentage is gradually
increasing following quarters, especially the percentage of the 1st quarter in 2011 is 65,7%
Median and mean door-to-balloon time are gradually reducing following quarters: 146/130
minutes (2009) compared to 94/81 minutes (1st/2011)
Conclusion: Improving strategies to reduce door-to-balloon time in STEMI patients
underwent PPCIs at Gia Dinh hospital get an initial successful step.We need to sustain this
improvement, increase the percentage of PPCIs avchied door-to-balloon time less 90
minutes.Besides,reducing this time as short as possible is our goal for remarkable changing
mortality rate, initial and long-term prognosis of STEMI patients
Keywords: ST-segment elevation myocardial infarction (STEMI), Primary Percutaneous

Coronary Intervention (PPCI), Culprit lesion, Door to balloon time







- 

    
-



- 
- 

- 
- bóng 





-

- -
- 


 




 03/2011.

 



- 03/2011)











- 

 





9 - 03/2011)




%

 
2,5/1
209/84

 

36 - 55 
56 -



1,7
31,4
47,1
19,8


5
92
138
58




RLCH Lipid



Béo phì


61,8
60,1
38,2
16,0
9,2
8,2
7,2
64,9

181
176
112
47
27
24
21
200


3 - 


59,4
27,3
13,3

174
80
39


%

I
II
III
IV
74,0
14,0
1,4
10,6
217
41
4
31
IMI



Trung bình
Cao
61,8

22,2
16,0
181
65
47



%






Bên cao

11,9
14,0
20,2
3,1
1,0
1,3
(35)
(41)
(59)
(9)
(3)
(4)

51,5
(151)

- 
Sau - 
34,1
10,5
1,7
(100)
(31)
(5)

46,3
(136)

2,1
(6)
2,1 (6)


%

Thân chung vành trái


- xa, nhánh chéo


0,7

48,5
32,4
16,1
43,0
7,8
(2)
(142)
(95)
(47)
(126)
(23)
- 
- 
- bóng
(phút)


2010  2011 (sau)

<90
90 - 119

10,0 (8)
32,0 (26)
57,3 (46)
52,6 (112)
19,8 (42)
27,6 (59)
 






10,0 (8/80)
Quí 1/2010 (sau) n = 45
46,7 (21/45)
Quí 2/2010 (n = 40)
42,5 (17/40)
Quí 3/2010 (n = 52)
50 (26/52)
Quí 4/2010 (n = 38)
60,5 (23/38)
Quí 1/2011( n = 38)
65,8 (25/38)


-

- 


gian (phút)
Trung bình th.gian (phút)

130
146
Quí 1/2010 (sau) n = 45
93
112

Quí 2/2010 n = 40
104
116
Quí 3/2010 n = 52
90
113
Quí 4/2010 n = 38
82
96
Quí 1/2011 n = 38
81
94



- 



2009
n = 80

2010 -2011
n = 213
p
- 
207,3 ± 212,3 (0 - 1370)
208,8 ± 243,1 (4 - 1340)
0,964
- 

26,5 ± 32,5 (5 - 245)
27,1 ± 37,8 (4 - 315)
0,875
- Cathlab
60,4 ± 42,5 (10 - 190)
40,1 ± 33,7 (5 - 270)
<0,001
- Cathlab
86,7 ± 56,8 (15 - 275)
67,2 ± 51,3 (10 - 330)
0,006
Cathlab - Kim
12,5 ± 13,4 (5 - 105)
9,1 ± 6,5 (5 - 45)
0,036
Kim - Nong bóng
46,6 ± 18,1 (20 - 105)
30,7 ± 15,6 (10 - 108)
<0,001
- Bóng
145,9 ± 59,2 (57 - 330)
107 ± 54,9 (30 - 355)
<0,001



   










T- II / Killip III - 

Killip I - II/ III- 
 











- bóng kéo dà


               
 

 ; Võ Thành Nhân [3]: 40,4 %: 48,2 %: 9,5%.
- bóng
Nghiên c-  

- 
- 
-
- bóng
- bóng trên 120 phút


         
- 


 -




- 
- to - Balloon Qua
 


- 

- bóng [6] [8],[10], [13]

- -
             
- 
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- 
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- 
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 
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


-  

-  :
-  
-


-

-  ngoài:
E.Bradley và c.s [8]: 76,4 % , David M. Nestler và c.s [6]: 81% Lee Chi - Hang và c.s [10]: 67,4%
- 
-  quý, quý


- - bóng: 131 phút
-  ngoài: David M.Nestler và
- Hang và c.s [10]: 72 phút

 - 
- 
 
hi vào phòng cath--


 - bóng







công tác ch


         -    


- 



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