急性ST段抬高型心肌梗死绿色通道在医联体模式下基层医院中的应用效果  

Applicative effect of the green channel of ST-segment elevation myocardial infarction in primary hospitals under the mode of medical union

作　　者：阮小贞 董静[2] 于纯文[2] 文刚 RUAN Xiao-zhen;DONG Jing;YU Chun-wen;WEN Gang(Department of Emergency,Xintang Hospital of Zengcheng District of Guangzhou City,Guangdong Province,Guangzhou 511340,China;Department of Emergency,Nanfang Hospital of Southern Medical University,Guangdong Province,Guangzhou 510515,China)

机构地区：[1]广州市增城区新塘医院急诊科,广东广州511340 [2]南方医科大学南方医院急诊科,广东广州510515

出　　处：《中国当代医药》2019年第23期177-180,共4页China Modern Medicine

基　　金：广东省医学科学技术研究基金项目(A2019351)

摘　　要：目的探讨医联体模式下基层医院急性ST段抬高型心肌梗死绿色通道的优越性。方法选取广州市增城区新塘医院急诊2016年1月~2018年12月接诊的82例ST段抬高型心肌梗死并实行转运行经皮冠状动脉介入治疗(PCI)患者。2017年6月起广州市增城区新塘医院规范医联体基层医院急性ST段抬高型心肌梗死绿色通道建设,以此为节点,将入选患者分为医联体前组(A组,42例)和医联体后组(B组,40例)。A组未实行医联体,B组实行医联体模式。比较两组患者的确诊时间、到PCI时间、并发症发生率和1周死亡率、总住院天数和PCI手术费外住院费用以及基层医院首诊满意度。结果B组患者的确诊时间、到PCI时间和总住院天数都明显短于A组(P<0.05),心律失常和心力衰竭发生率、1周死亡率以及PCI手术费外住院费用明显低于A组(P<0.05);B组的基层医院首诊非常满意度明显更高(P<0.05)。结论医联体模式下基层医院ST段抬高型急性心肌梗死绿色通道能有效缩短确诊时间、到PCI时间和总住院天数,降低并发症发生率以及1周死亡率,减少PCI手术费外住院费用,且基层医院首诊非常满意率高,值得在临床推广。Objective To investigate the advantages of the green channel of ST-segment elevation myocardial infarction in primary hospitals under the mode of medical union.Methods A total of 82 patients with ST-segment elevation myocardial infarction who were admitted to Xintang Hospital of Zengcheng District of Guangzhou City from January 2016 to December 2018 were selected and transferred to percutaneous coronary intervention(PCI).Since June 2017,Xintang Hospital of Zengcheng District of Guangzhou City had standardized the construction of green channel for acute ST-segment elevation myocardial infarction in primary hospitals of medical union.Based on this,the selected patients were divided into the pre-medical association group(group A,42 cases)and the post-medical association group(group B,40 cases).Group A did not implement the medical union model,group B implemented the medical union model.The diagnostic time,the time to PCI,the incidence of complications and one-week mortality,the total hospitalization days,the hospitalization expenses excluding PCI operation fees,and the satisfaction of the first visit in primary hospitals were compared between the two groups.Results The time of diagnosis,the time to PCI and the total days during hospitalization in group B were significantly shorter than those in group A(P<0.05).The incidence of arrhythmia and heart failure,1-week mortality rate and the total costs during hospitalization in group B were obviously lower than those in group A(P<0.05).In addition,the great satisfaction of group B after the first diagnosis in the primary hospital was clearly higher(P<0.05).Conclusion The green channel of ST-segment elevation myocardial infarction in primary hospitals under the mode of medical union can effectively shorten the time of diagnosis,the time to PCI and the total days during hospitalization,reduce the occurrence of complications and 1-week mortality rate,as well as the hospitalization expenses excluding PCI operation fees.In addition,the great satisfaction after the first diagno

关 键 词：医联体 基层医院 心肌梗死 ST段抬高 

分 类 号：R542.22[医药卫生—心血管疾病]