Læknablaðið - 15.02.2008, Page 15

FRÆÐIGREINAR
BRÁÐAR KRANSÆÐAR
innan 60-120 mínútna frá því einkenni hefjast er
bráð kransæðaþræðing besti kosturinn (20). Að
öðrum kosti er segaleysandi meðferð hið rökrétta
bráðaúrræði.
Sú rannsókn sem hér er kynnt hefur ýmsar tak-
markanir. Hún er afturskyggn og ekki nægilega
fjölmenn eða umfangsmikil til að kanna hvaða
afleiðingar tafir eða seinkuð viðbrögð hafa á afdrif
sjúklinga. Upplýsingarnar eru takmarkaðar við
það sem skráð var í sjúkra- og aðgerðarskýrslur
og gagnaöflun úr sjúkraskrám var ekki sannreynd
með annarri athugun. Aðeins hjá fáum sjúklingum
voru tiltækar upplýsingar um tímann sem leið
frá upphafi einkenna til upphafs meðferðar sem
að sjálfsögðu ræður miklu um afdrif. Ekki voru
heldur upplýsingar um flutningstíma eða hvaðan
sjúklingar komu og því ekki unnt að bera saman
sjúklinga eftir því hvort þeir komu um langan veg
eða skamman.
Ályktun
Reynslan fyrsta árið af stöðugri vakt á Landspítala
til að meðhöndla bráða kransæðastíflu með ST-
hækkun með tafarlausri kransæðaþræðingu og
kransæðavíkkun er mjög góð. Meðaltími frá inn-
lögn til þræðingar er langt innan við alþjóðleg
viðmiðunarmörk og fer í örfáum tilfellum yfir 90
mínútur. Meðallegutími er einnig stuttur og dán-
artíðni lág.
Heimildir
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