急性ST段抬高型心肌梗死患者救治中胸痛中心模式的应用价值分析  

Application value of chest pain center mode in the treatment of acute ST segment elevation myocardial infarction

作　　者：陈玲 张馥 曾伯石 何鹏[1] 李琴[1] 何勃[2] CHEN Ling;ZHANG Fu;ZENG Bo-shi;HE PENG;LI Qin;HE Bo(Department of Emergency,Xiaogan City CentralHospital,Hubei,Xiaogan 432500,China;Department of Cardiology,Renmin Hospital of Wuhan University,Wuhan 430060)

机构地区：[1]孝感市中心医院急诊科,湖北孝感432500 [2]武汉大学人民医院心血管内科,武汉430060

出　　处：《中国医学前沿杂志（电子版）》2019年第3期68-71,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：2017~2018年度湖北省卫生计生委青年人才项目(WJ2017Q004)

摘　　要：目的探讨急性ST段抬高型心肌梗死(ST segment elevation myocardial infarction,STEMI)患者救治中胸痛中心模式的应用价值。方法回顾性分析2017年1月至2018年5月孝感市中心医院急诊科收治的104例急性STEMI患者的临床资料,将运行胸痛中心模式前的62例患者纳入对照组,将运行胸痛中心模式后的42例患者纳入研究组,比较两组患者急诊分诊评估时间、生化指标检查时间、心电图检查时间、急诊救治总时间、进门-球囊扩张(door-to-balloon,D-to-B)时间、住院天数、手术时间、医疗费用及住院期间并发症发生率。结果研究组患者急诊分诊评估时间、生化指标检查时间、心电图检查时间、急诊救治总时间、D-to-B时间、住院天数均显著短于对照组(P_均<0.05),医疗费用和院内病死率均显著低于对照组(P_均<0.05)。两组患者手术时间及心源性休克、支架内血栓、消化道出血发生率比较均无显著差异(P_均> 0.05)。结论在急性STEMI患者救治中应用胸痛中心模式,可有效缩短救治时间,改善患者预后,值得临床推广。Objective To explore the application value of chest pain center mode in the treatment of acute ST segment elevation myocardial infarction(STEMI).Method The clinical data of 104 patients with acute STEMI admitted to the emergency department of Xiaogan City Central Hospital from January 2017 to May 2018 were analyzed retrospectively,62 patients before the chest pain center model were included in control group,and 42 patients after the chest pain center model were included in study group,the emergency triage evaluation time,biochemical index examination time,electrocardiogram examination time,total time of emergency treatment,the time of door-to-balloon(D-to-B),the days of hospitalization,the time of operation,medical expenses and incidence of complications during hospitalization were compared between the two groups.Result The emergency triage evaluation time,biochemical index examination time,electrocardiogram examination time,total time of emergency treatment,the time of D-to-B,the days of hospitalization of study group were significantly shorter than those of control group(Pall<0.05),medical expenses and inhospital mortality were significantly lower than those of control group(Pall<0.05).There were no significant differences in operation time,incidence of cardiogenic shock,stent thrombus and gastrointestinal bleeding between the two groups(Pall>0.05).Conclusion The application of the center pattern of chest pain in the treatment of acute STEMI can effectively shorten the treatment time and improve the prognosis of the patients,it is worthy of clinical promotion.

关 键 词：ST段抬高型心肌梗死 急诊救治 胸痛中心 预后 

分 类 号：R542.22[医药卫生—心血管疾病]