胸痛中心的建立对急性前壁心肌梗死诊疗趋势的影响  

Effect of establishing chest pain center on the diagnosis and treatment of acute anterior wall myocardial infarction

作　　者：古丽娜尔.白托拉 马依彤[1] 郑颖颖[1] 陈铀[1] 张雨晨[1] 赵倩[1] 马小力 马翔[1] Gulinaer Baituola;MA Yitong;ZHENG Yingying;CHEN You;ZHANG Yuchen;ZHAO Qian;MA Xiaoli;MA Xiang(Department of Heart Center,The First Affiliated Hospital,Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院心脏中心,乌鲁木齐830054

出　　处：《新疆医科大学学报》2018年第12期1455-1458,1464,共5页Journal of Xinjiang Medical University

基　　金：国家自然科学基金(81000089)

摘　　要：目的探讨胸痛中建立前后402例急性前壁心肌梗死患者诊疗模式变化趋势。方法选择新疆医科大学第一附属医院2013年1月-2018年6月402例因急性前壁心肌梗死且有急诊介入手术指征而就诊患者的住院病历,分析胸痛中心成立前后患者诊疗模式的变化。结果胸痛中心成立后,胸痛发病至首次医疗接触时间缩短、就诊-球囊扩张时间缩短,术前双抗使用情况好转,床旁快速肌钙蛋白检测比例提高,24小时内他汀类药物使用率增加,β受体阻滞剂的使用率增加,ACEI/ARB使用率增加,Killip分级Ⅲ级～Ⅳ级例数增加但死亡例数减少,行急诊经皮冠状动脉介入术比例明显增加,与胸痛中心成立前相比,差异均有统计学意义(P <0.05)。结论 2013-2018年,我院急性前壁心肌梗死患者医疗质量明显改善,Killip分级≥Ⅲ级患者治疗结局明显改善。Objective To explore the trend of diagnosis and treatment of402patients with acute anterior myocardial infarction before and after the establishment of chest pain.Methods From January2013to June2018,402hospitalized patients with acute anterior wall myocardial infarction and indications of emergency interventional surgery were selected to analyze the changes of patients'diagnosis and treatment mode before and after the establishment of chest pain center.Results After the establishment of the Chest Pain Center,the time from the onset of chest pain to the first medical contact was shortened,the time from consultation to balloon dilatation was shortened,the use of bivalent antibodies was improved before operation,the proportion of rapid troponin detection by bedside was increased,the use of statins was increased within24hours,the use of beta blockers was increased,the use of ACEI/ARB was increased,and Killp was increased.GradeⅢtoⅣincreased,but the number of deaths decreased,and the proportion of emergency percutaneous coronary intervention increased significantly.The difference was statistically significant compared with that before the establishment of chest pain center(P<0.05).Conclusion During the period from January2013to June2018in our hospital,the medical quality of patients with acute anterior wall myocardial infarction improved significantly in our hospital.

关 键 词：急性前壁心肌梗死 治疗结局 诊疗模式 

分 类 号：R459.7[医药卫生—急诊医学]