微信平台在优化急诊直接经皮冠状动脉介入治疗救治流程中的应用  

Application of WeChat APP in optimizing the rescue process in transferred primary percutaneous coronary intervention

作　　者：贺行巍[1] 赵虎[1] 丁晨[1] 王洪杰[1] 刘婉君[1] 徐昶[1] 周强[1] 蒋建刚[1] 严江涛[1] 肖智超[1] 郭小梅[1] 汪道文[1] 曾和松[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院心内科,湖北武汉430030

出　　处：《中国介入心脏病学杂志》2017年第1期27-30,共4页Chinese Journal of Interventional Cardiology

摘　　要：目的探讨微信平台在急性ST段抬高心肌梗死(STEMI)患者的转运和救治流程中的应用效果。方法建立以华中科技大学同济医学院附属同济医院胸痛中心为核心,"120"院前急救系统、急诊科以及武汉市周边区域不具备直接经皮冠状动脉介入治疗(PPCI)能力的各基层医院参与的微信群。利用微信平台对疑似STEMI患者的病史和心电图等资料进行传输共享。对比分析微信平台应用之前(2014年12月1日至2015年8月31日)和之后(2015年9月1日至2016年5月31日)两组患者首次医疗接触至球囊扩张(FMC-to-B)时间、入门至球囊扩张(D-to-B)时间、住院期间死亡率以及住院天数的差异。结果微信平台应用前行PPCI的急性STEMI患者共计91例,微信平台应用后行PPCI的患者119例。两组患者支架置入、住院期间死亡率、住院时间比较,差异均无统计学意义(均P>0.05);而微信平台应用后患者的FMC-to-B时间[(115.6±34.0)min比(197.1±45.5)min,P<0.001]和D-to-B时间[(80.4±9.3)min比(133.6±36.7)min,P=0.034]时间均较微信平台应用前患者显著减少,差异均有统计学意义。结论微信平台的应用有助于不具备PPCI能力的医院对STEMI患者进行无缝隙转诊,明显缩短了FMC-to-B和D-to-B时间,提高了救治效率。Objective To evaluate the efficacy of utilizing the WeChat App in the transfer and rescue process for patient with acute ST-segment elevated myocardial infarction （STEMI）. Methods A communication platform utilizing the WeChat APP was establised with the chest pain center of Tongji Hospital （Wuhan, China） as the core center, and included the 120 pre-hospital emergency system, emergency departments, and primary PCI-incapable local hospitals in the surrounding area of Wuhan City. We shared the medical history, electrocardiogram （ ECG ） , etc, obtained from cases of suspected STEMI using the Wechat APP. First medical contact to balloon （FMC-to-B） time, door to balloon （D-to-B） time, in-hospital mortality, and the length of hospital stay were compared before and after the establishment of the Wechat group. Results The number of STEMI patients transferred for primary PCI without and with the Wechat App application were 91 and 119, respectively. Compared to the pre-WeChat group establishment era, theFMC-to-B [（197.1±45.5）min vs. （115.6±34.0）min, P〈0. 001] and D-to-B [（133.6±36. 7 ） min vs. （ 80. 4± 9. 3 ） min, P = 0. 034 ] time were significantly shortened after the built-up of the Wechat group. There were no significant differences in in-hospital mortality and the length of hospital stay before and after the WeChat group application （ All P 〉 0. 05 ）. Conclusions Application of WeChat platform can contribute to enhance seamless patients transfer for hospitals without primary PCI capability, shorten the FMC-to-B and D-to-B time and to improve treatment efficiency.

关 键 词：急性ST段抬高心肌梗死 经皮冠状动脉介入治疗 微信平台 

分 类 号：R541.4[医药卫生—心血管疾病]