胸痛中心管理模式对急性ST段抬高型心肌梗死术前救治效率的影响  

Chest pain center management mode for acute ST segment elevation myocardial infarction influence of preoperative treatment efficiency

作　　者：周欣荣[1] 赵倩[1] 杨毅宁[1] 陈铀[1] 王燕[1] 张雨晨[1] 马翔[1] 马依彤[1] ZHOU Xinrong;ZHAO Qian;YANG Yining;CHEN You;WANG Yan;ZHANG Yuchen;MA Xiang;MA Yitong(Department of Heart Center,The First Affiliated Hospital of 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1465-1468,共4页Journal of Xinjiang Medical University

基　　金：国家自然科学基金(81873490)

摘　　要：目的探讨胸痛中心管理模式对急性ST段抬高型心肌梗死患者术前救治效率的影响。方法选择2015年4月-2017年10月经120急救系统、本院急诊科或其他医疗机构转运来院的急性胸痛,经首份心电图证实为两个或两个以上相邻导联ST段抬高的患者共454例为研究对象,其中男性345例(75.99%),女性109例(24.01%)。分为2015年组、2016年组和2017年组,观察胸痛中心建立前、建立后1年及建立后2年STEMI患者发病-首次医疗接触(FMC)时间、FMC-球囊扩张(FMC2B)时间和从挂号就诊到球囊扩张的时间(D2B)等指标的差异。结果 (1)2015、2016和2017年STEMI患者发病至FMC、FMC2B时间、D2B时间、首份心电图时间和签署知情同意书时间逐年缩短,差异均有统计学意义(P <0.05)。2015-2017年FMC2B达标率呈逐年增高趋势(P<0.05)。2015-2017年救护车或转诊到院比例逐年增高。(2)2015-2017年患者院内病死率、PCI术后院内心力衰竭率逐年降低;心脏重症监护室入住时间、总住院时间有缩短趋势,总费用逐年降低,差异均有统计学意义(P <0.05)。结论胸痛中心管理模式可有效的提高急性ST段抬高型心肌梗死术前救治效率。Objective To explore the management mode of chest pain center for STEMI patients.The effect of preoperative treatment efficiency.Methods From April2015to October2017,454patients with acute chest pain transported to our hospital by120first aid systems,emergency departments or other medical institutions were selected.The first electrocardiogram confirmed that there were two or more adjacent leads with ST segment elevation.Among them,345were males(75.99%)and109were females(24.01%).The patients were divided into2015group,2016group and2017group.The differences of incidence-FMC,FMC2B and D2B of STEMI patients before and1year after the establishment of chest pain center and2years after the establishment of STEMI were observed.Results(1)The time from onset to FMC,FMC2B,D2B,first ECG and signing informed consent of STEMI patients in2015,2016and2017de-creased year by year,with statistical significance(P<0.05).From2015to2017,the compliance rate of FMC2B increased year by year(P<0.05).The proportion of ambulances or referrals to hospitals increased year by year from2015to2017.(2)From2015to2017,in-hospital mortality and heart failure rate after PCI decreased year by year,while the length of stay and total hospitalization time in cardiac intensive care unit tended to shorten,and the total cost decreased year by year,with statistical significance(P<0.05).Conclusion Chest pain center management mode can effectively improve the preoperative treatment efficiency of acute ST segment elevation myocardial infarction.

关 键 词：ST段抬高型心肌梗死 经皮冠状动脉介入术 首次医疗接触 首次医疗接触到球囊扩张 入门到球囊打开 

分 类 号：R459.7[医药卫生—急诊医学]