影响急诊经皮冠状动脉介入治疗门-球时间的可控性因素分析  

Factors of Door-to-Balloon time in emergency Percutaneous coronary intervention(PCI)

作　　者：占德进[1] 曾玉玲[1] 徐秀良[1] 林英娜 罗瑞英[1] 

机构地区：[1]福建医科大学附属宁德市医院心内科,352100

出　　处：《白求恩医学杂志》2016年第5期561-563,共3页Journal of Bethune Medical Science

摘　　要：目的探讨影响急诊经皮冠状动脉介入治疗(PCI)门-球时间的可控性因素,以期更好地控制门-球时间。方法选取我院收治的急性ST段抬高型心肌梗死行急诊PCI术患者182例,分析患者从门(急)诊就诊至PCI术中球囊扩张完成时间,分别计算门(急)诊就诊至病房时间,病情评估时间,签署知情同意书时间,病房至导管室并开始穿刺桡(股)动脉时间,桡(股)动脉穿刺开始至球囊扩张完成时间;分析各时间段耗时情况并与国内部分地区进行比较。结果 182例患者的门-球时间为(60.50±20.62)min,门(急)诊就诊至病房时间为(12.85±8.63)min,病情评估时间(8.52±3.14)min,签署知情同意书时间(25.74±16.88)min,病房至导管室并开始穿刺桡(股)动脉时间(3.12±1.14)min,桡(股)动脉穿刺开始至球囊扩张完成时间(25.46±10.72)min。本地区门-球时间低于其他7个地区(P<0.01);也低于我国首批通过认证的5家胸痛中心的平均值(72±23)min。结论减少门-球时间仍有较大空间,尽快取得患者及家属理解并签署同意书以及加强门(急)诊绿色通道建设是减少门-球时间的重要因素。Objective To shorten the Door-to-Balloon （D2B） time by analyzing the controllable factors of D2B time in emer- gency percutaneous coronary intervention. Methods One hundred and eighty-two patients with ST-elevated myocardial infarction （STEMI） who were undergoing emergency PCI admitted in our hospital. Time interval between Outpatient/emergency department and ward, duration of evaluation time, duration of the operation consent conversation and signature, time interval from ward to the catheter room and start to puncture the radial/femoral artery and interval from radial/femoral artery puncture to balloon. All time duration was compared with that in the other domestic regions. Results D2B time was （60. 50 ± 20. 62） min, outpatient/emergency department to ward time was （12. 85 ± 8.63 ）min, evaluating duration was （8. 52 ± 3.14）min, duration of the operation consent conversation and sig- nature was （25.74 ± 16. 88 ）min, time interval from ward to the catheter room and start to puncture the radial/femoral artery was （3. 12 ± 1.14）min,interval from radial/femoral artery puncture to balloon was （25.46 ± 10. 72）min. Compared to developed regions in do- mestic,the overall D2B time is less time-consuming, but duration of the operation consent conversation and signature and interval be- tween Outpatient/emergency department and ward were longer. Compared to the data of 5 chest pain centers first certified, the overall D2B time was also more time-consuming, duration of the operation consent conversation and signature and interval between Outpatient/ emergency department and ward were longer,there is great space for improvement. Conclusion There is a great improvement for re- ducing the D2B time, and the most important factor is to gain understanding of patients and their family members, sign the consent form and establish the outpatient/emergency easy access as quickty as possible.

关 键 词：门-球时间 急诊PCI术 可控性因素 

分 类 号：R541.4[医药卫生—心血管疾病]