胸痛中心模式与常规诊疗流程对ST段抬高型心肌梗死患者急诊救治效果的影响  

The effect of the model of chest pain center and routine diagnosis and treatment process on the emergency treatment of STEMI patients

作　　者：郭继东[1] 赵雪燕[2] 赵媛媛[1] 杜铮 王莉 刘亚 王喜萍[1] GUO Ji-dong;ZHAO Xue-yan;ZHAO Yuan-yuan(Department of cardiovascular medicine,Shihezi people's Hospital,Xinjiang Uygur Autonomous Region,Shihezi 832000,China;Coronary heart disease center of Fuwai Hospital,National Cardiovascular Center,Chinese Academy of Medical Sciences,Beijing 100037,China)

机构地区：[1]石河子市人民医院心血管内科,新疆石河子832000 [2]中国医学科学院北京协和医学院国家心血管病中心阜外医院冠心病中心,北京100037

出　　处：《吉林医学》2022年第2期328-330,共3页Jilin Medical Journal

基　　金：新疆生产建设兵团科技创新人才计划[项目编号:2020CB012]。

摘　　要：目的:探讨胸痛中心模式与常规诊疗流程对ST段抬高型心肌梗死(STEMI)患者急诊救治效果的影响。方法:参考中国胸痛中心要求建立胸痛中心并建立快速诊治流程。选取2018年3月~2020年3月STEMI患者为研究对象,将2019年3月1日启动胸痛中心建设前收治的患者为观察组,将启动胸痛中心后收治的患者为对照组,观察在两种模式下患者发病-球囊扩张(S2B)时间、首次医疗接触-球囊扩张(FMC2B)时间、进入医院大门-球囊扩张(D2B)时间的差异以及两组患者住院1周时彩色多普勒超声下左室射血分数(LVEF)、住院期间心力衰竭(Killip分级≥2级)发生率、院内病死率的差异。结果:与对照组相比,观察组患者S2B、FMC2B、D2B更短,治疗1周后LVEF更高,心力衰竭发生率及院内病死率更低,差异具有统计学意义(P<0.05)。结论:在胸痛中心模式下,能够有效提高STEMI患者的收治效率,及时进行再灌注治疗,从而有效改善患者的短期预后。Objective To explore the effect of chest pain center mode and conventional diagnosis and treatment process on the emergency treatment of patients with ST segment elevation myocardial infarction.Method According to the requirements of China chest pain center,establish a chest pain center and establish a rapid diagnosis and treatment process.Patients with ST segment elevation myocardial infarction admitted to our hospital from March,2018 to March,2020 were selected as the study objects.Patients who were cleaned up before the establishment of the chest pain center on March,2019 were taken as the observation group,and patients who were admitted after the establishment of the chest pain center were taken as the control group to observe the onset of balloon dilatation(symptom onset to)in the improved bovine model Balloon(S2B)time,first medical contact to balloon,door to hospital the difference of the time of balloon(D2B)and the difference of left ventricular ejection fraction(LVEF),the incidence of heart failure(Killip grade≥2)and the mortality in hospital between the two groups.Results Compared with the control group,the patients in the observation group had shorter S2B,FMC2B and D2B,higher LVEF,lower incidence of heart failure and hospital mortality after one week of treatment(P<0.05).Conclusion In the model of chest pain center,it can effectively improve the treatment efficiency of STEMI patients,timely reperfusion treatment,so as to effectively improve the short-term prognosis of patients.

关 键 词：胸痛中心 ST段抬高型心肌梗死 球囊扩张 治疗效率 预后 

分 类 号：R542.22[医药卫生—心血管疾病]