优化院前院内急救流程对急性STEMI患者首次医疗接触至球囊扩张时间的影响  

Influence of optimizing pre hospital first aid process on the first medical contact to balloon dilation time in patients with acute STEMI

作　　者：黄海燕 陈英俊 陈巧玲 HUANG Haiyan;CHEN Yingjun;CHEN Qiaoling(The Traditional Chinese Medicine Hospital of Dongguan City,Dongguan 523000,China)

机构地区：[1]广东省东莞市中医院,广东东莞523000

出　　处：《中国医药科学》2018年第13期165-168,174,共5页China Medicine And Pharmacy

基　　金：广东省东莞市医疗卫生科技计划项目(2015105101247)

摘　　要：目的观察优化院前院内急救流程对急性ST段抬高型心肌梗死(STEMI)患者首次医疗接触至球囊扩张(FMC-B)时间的影响。方法收集2013年7月~2017年10月,东莞市中医院120救急团队院前转运来院,接受直接经皮冠脉介入(PCI)治疗的急性STEMI患者共82例。其中,以2015年7月~2017年10月实施优化流程下,接受治疗的52例患者作为观察组;以2013年7月~2015年7月,实施优化流程前,接受治疗的30例患者,作为对照组。以首次医学接触(FMC)为时间起点,记录两组患者首份心电图完成时间、首份心电图诊断时间、到达医院时间、启动介入团队时间、球囊扩张时间。结果观察组首次医疗接触至到达医院时间(FMC-D)较对照组延长(P<0.05),但入门至球囊扩张时间(D-B)、FMC-B时间均较对照组明显缩短(P<0.05)。院前启动介入团队的D-B时间较两组院内启动介入团队的D-B时间明显缩短(P<0.05)。结论优化院前院内流程,形成院前急救与院内急救的良好衔接,大大缩短了急性STEMI患者D-B时间,使院前救治的急性STEMI的FMC-B时间减少。优化的流程在急救工作发挥了效益。Objective To observe the influence of optimizing pre hospital first aid process on the first medical contact to balloon dilatation(FMC-B)time in patients with acute ST segment elevation myocardial infarction(STEMI).Methods Eighty-two patients with acute STEMI and who received direct percutaneous coronary intervention(PCI)in 120 emergency team of Dongguan Chinese Medicine Hospital transferred to the hospital before the hospital from July 2013 to October 2017 were collected.And 52 patients were received the treatment under the implementation optimization process from July 2015 to October 2017 were selected as the observation group,while 30 patients were received treatment before the implementation optimization process from July 2013 to July 2015 were selected as control group.Then,with the first medical contact(FMC)as the starting point,the first time of ECG completion,the first time of ECG diagnosis,the time of arrival in hospital,the time of initiation of intervention team,and the time of balloon dilation of two groups were recorded.Results The first medical contact to hospital time(FMC-D)in the observation group was longer than that in the control group(P<0.05).But the time from entry to balloon dilation(D-B)and FMC-B time were significantly shorter than those in the control group(P<0.05).The start the D-B time of the intervention team in pre hospital was significantly shorter than that start the D-B time of the intervention team in hospital(P<0.05).Conclusion The optimize the pre hospital process and form a good connection between pre hospital care and first aid in hospital,which can greatly shorten the D-B time in patients with acute STEMI,and reduce the FMC-B time of acute STEMI for pre hospital treatment,thus the optimized process has played an effective role in first aid work.

关 键 词：优化流程 急性ST段抬高型心肌梗死 直接经皮冠脉介入治疗 首次医疗接触至球囊扩张时间 

分 类 号：R459.7[医药卫生—急诊医学]