胸痛中心模式院外急救单元救治STEMI患者流程研究  

Study on the treatment process of STEMI patients with chest pain cen-ter model pre-hospital emergency unit

作　　者：林爱进 王静 王君业 冉飘 徐梅[1] 孙锦平[2] LIN Aijin;WANG jing;WANG junye;RAN piao;XU Mei;SUN Jinping(The Affiliated Hospital of Qingdao Universtity,Qingdao Shandong 266035,China)

机构地区：[1]青岛市急救中心,山东青岛266035 [2]青岛大学附属医院,山东青岛266555

出　　处：《中国急救复苏与灾害医学杂志》2020年第8期927-929,936,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：国家重点研发计划(编号:2017YFC1307701);青岛市民生科技计划项目(编号:19-6-1-53-nsh)。

摘　　要：目的建立适合胸痛中心模式的院外救治流程,观察对急性ST段抬高型心肌梗死(STEMI)患者院外救治时间及院外救治效率的改善作用.方法制定"急救单元院外STEMI患者急救流程及规范",分别于规范实施前、后选择STEMI患者79例、87例,评估急救效果.结果规范流程实施后,驶向现场时间、首次医疗接触时间、建立静脉通道时间、到达导管室时间、首次心电图时间、院外急救时间分别为(0.54±0.21)、(18.11±5.25)、(3.75±1.19)、(41.32±3.23)、(5.11±2.16)、(8.34±1.12)min,均低于实施前的(1.12±0.34)、(24.32±5.17)、(9.32±2.13)、(96.65±6.16)、(15.32±3.11)、(19.00±1.27)min,差异具有统计学意义(P<0.01).心电图远程传输比率提高44.0%,规范流程实施后绕行急诊到导管室的比例是71%.结论建立的胸痛中心模式院外急救单元救治STEMI患者流程,缩短了院外救治时间,对STEMI患者救治赢得时间,提高了院外急救效率.Objective To establish pre-hospital treatment process suitable for the chest pain center model,and to observe the improving ffect of pre-hospital treatment time and pre-hospital treatment fficiency of acute ST-segment elevation myocardial infarction(STEMI).Methods Pre-hospital treatment flow and standard of STEMI patients before and after the implementation of the standard were formulated.79 and 87 STEMI patients were selected before and after the implementation of the standard to evaluate the ffeet of pre-hospital treatment.Results After the implementation of the standardization process,the time of arrival to the scene,the time of the first medical contact,the time to establish the venous channel,the time to reach the catheter room,the long-term ECG transmission time and the pre-hospital emergency time were(0.54±0.21)min,(18.11±5.25)min,(3.75±1.19)min,(41.32±3.23)min,(5.11±2.16)min,(8.34±1.12)min,lower than those before the implementation of the standardization process(1.12±0.34)min,(24.32±5.17)min,(9.32±2.13)min,(96.65±6.16)min(15.32±3.11)min and(19.0011.27)min,the difference was statistically significant(P<0.01).The ECG remote transmission rate increased by 44.0%,and the ratio of bypassing the emergeney department to the catheterization room after the implementation of the standardized process was 71%.Conclusion The established chest pain center model pre hospital emergency unit treatment process for STEMI patients,shorten the pre hospital treatment time,win the time for STEMI patients,improve the efficiency of pre hospital emergency.

关 键 词：胸痛中心 急性ST段抬高型心肌梗死 急救单元 优化流程 

分 类 号：R459[医药卫生—治疗学]