ISSN 2097-6046（网络）
ISSN 2096-7446（印刷）
CN 10-1655/R
主管：中国科学技术协会
主办：中华护理学会
中华急危重症护理杂志

中华急危重症护理杂志 ›› 2026, Vol. 7 ›› Issue (6): 689-696.doi: 10.3761/j.issn.2096-7446.2026.06.009

• 心脏手术康复护理专题 • 上一篇    下一篇

急性ST段抬高型心肌梗死患者入院至球囊扩张延迟率及影响因素的Meta分析

李静1(), 胡敏2, 陆小英3,*(), 杨亚亚2, 陈雪梅4, 胡冰2   

  1. 1 同济大学医学院 上海市 200092
    2 海军军医大学第一附属医院急诊科 上海市 200433
    3 海军军医大学第一附属医院护理部 上海市 200433
    4 海军军医大学护理系 上海市 200433
  • 收稿日期:2025-08-21 出版日期:2026-06-10 发布日期:2026-06-02
  • 通讯作者: 陆小英 E-mail:975578057@qq.com;luxiaoyingjoy@163.com
  • 作者简介:李静：女，本科（硕士在读），护师，E-mail：975578057@qq.com
    第一联系人：

    李静：选题、文献检索、资料整理、分析数据、论文撰写；胡敏、杨亚亚、胡冰：文献检索、质量评价、分析数据；陆小英：论文修改；陈雪梅：研究指导、论文修改、经费支持

Meta-analysis of delay rate from hospital admission to balloon dilation and influencing factors in patients with acute ST-elevation myocardial infarction

LI Jing1(), HU Min2, LU Xiaoying3,*(), YANG Yaya2, CHEN Xue-mei4, HU Bing2   

  1. 1 School of Medicine， Tongji University， Shanghai 200092， China
    2 Emergency Department， the First Affiliated Hospital of Naval Medical University， Shanghai 200433， China
    3 Nursing Department， the First Affiliated Hospital of Naval Medical University， Shanghai 200433， China
    4 Nursing Department， Naval Medical University， Shanghai 200433， China
  • Received:2025-08-21 Online:2026-06-10 Published:2026-06-02
  • Contact: LU Xiaoying E-mail:975578057@qq.com;luxiaoyingjoy@163.com

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摘要：

目的 了解急性ST段抬高型心肌梗死患者入院至球囊扩张（以下简称“门—囊时间”）延迟率及影响因素。 方法 系统检索中国生物医学文献数据库、中国知网、万方数据库、维普数据库、PubMed、Web of Science、Cochrane Library、Embase数据库中关于急性ST段抬高型心肌梗死患者院内门—囊时间延迟率及影响因素的相关文献，检索时间为建库至2025年7月31日。采用Stata 18.0和RevMan 5.4软件进行Meta分析。 结果 共纳入20篇文献。Meta分析结果显示，院内门—囊延迟发生率为42%。影响因素包括农村（OR=3.12）、非“120”来院（OR=2.52）、非工作日就诊（OR=2.15）、消化道疾病（OR=2.79）、女性（OR=1.41）、高龄（OR=1.39）、自费（OR=1.07）、糖尿病（OR=1.17）、肾脏疾病（OR=1.64）、外周血管疾病（OR=1.22）和教育程度高（OR=0.39）。结论 急性ST段抬高型心肌梗死患者院内门—囊延迟率较高，受多种因素影响。针对上述高危人群，医护人员应开展结构化筛查、落实优先分诊机制并建立介入团队24 h备班体系，同时系统性优化胸痛中心多学科协作流程，完善农村地区胸痛转诊网络建设。该研究可为构建个性化干预策略，落实指南推荐的门—囊延迟≤90 min目标提供循证依据。

关键词: 急性心肌梗死, 院内延迟, 门—囊时间, Meta分析, 循证护理学

Abstract:

Objective To investigate the rate and influencing factors of in-hospital door-to-balloon time delay in patients with acute ST-segment elevation myocardial infarction（STEMI）. Methods PubMed，Cochrane Library，Web of Science，Embase，CBM，CNKI，Wan Fang and VIP were systematically searched for related literature on the rate and influencing factors of in-hospital door-to-balloon time delay in patients with acute ST-segment elevation myocardial infarction，the search period was from the establishment of the databases until July 31，2025. Meta-an-alysis was performed using Stata 18.0 and RevMan 5.4. Results A total of 20 studies were included. The meta-analysis results showed that the in-hospital door-to-balloon time delay rate was 42%. The identified risk factors included rural residence（OR=3.12），non-ambulance admission（OR=2.52），presentation on non-working days（OR=2.15），history of gastrointestinal diseases（OR=2.79），female（OR=1.41），advanced age（OR=1.39），self-payment（OR=1.07），history of diabetes（OR=1.17），history of renal diseases（OR=1.64），history of peripheral vascular diseases（OR=1.22） and higher education level（OR=0.39）. Conclusion The in-hospital door-to-balloon delay rate in STEMI patients is relatively high and affected by multiple factors. For these high-risk populations，healthcare providers should conduct structured screening，prioritize triage protocols and establish a 24-hour on-call system for the interventional team. Meanwhile，multidisciplinary collaboration processes in chest pain centers should be systematically optimized，and the construction of chest pain referral networks in rural areas should be improved. This study provides an evidence-based basis for developing individualized intervention strategies and achieving the guideline-recommended goal of door-to-balloon delay≤90 minutes.

Key words: Acute Myocardial Infarction, In-Hospital Delay, Door To Balloon Time, Meta-Analysis, Evidence-Based Nursing