标准化急诊预检分诊对急诊胸痛患者救治效果的研究  

Study on the Effect of Standardized Emergency Pre-Examination and Triage on Emergency Chest Pain Patients

作　　者：刘霞蓉[1] 林彩霞[1] 傅小婷 LIU Xiarong;LIN Caixia;FU Xiaoting(Department of Emergency,East Hospital,Quanzhou First Hospital,Fujian,Quanzhou Fujian 362000,China)

机构地区：[1]福建省泉州市第一医院城东院区急诊科,福建泉州362000

出　　处：《中国卫生标准管理》2024年第13期132-136,共5页China Health Standard Management

摘　　要：目的评估标准化急诊预检分诊模式在急诊胸痛患者中的应用效果。方法选择2023年2—5月福建省泉州市第一医院城东院区急诊科接诊的50例急性胸痛患者为对照组,2023年6—9月福建省泉州市第一医院城东院区急诊科接诊的50例急性胸痛患者为研究组。对照组采用传统急诊预检分诊方法,研究组采用基于改良早期预警评分系统(modified early warning score,MEWS)的标准化急诊预检分诊模式。比较2组患者急诊处理时间、急性冠脉综合征患者首次医疗接触到球囊开通时间(first medical contact to balloon,FMC-to-B)、进入医院大门至球囊开通时间(door to ballon,D-to-B)、不良事件发生情况。结果研究组预检分诊时间[(2.2±0.5)min vs.(3.6±1.4)min]、首份心电图时间[(6.1±1.9)min vs.(8.9±2.6)min]、床旁即时检测完成时间[(21.4±3.2)min vs.(30.6±6.8)min]、急诊科停留时间[(40.2±7.6)min vs.(54.6±11.8)min]均短于对照组(P<0.05)。研究组急性冠脉综合征患者FMC-to-B[(50.4±9.3)min vs.(71.3±14.7)min]与D-to-B[(78.6±11.7)min vs.(106.9±15.4)min]短于对照组(P<0.05)。研究组心力衰竭、休克、心律失常累计发生率低于对照组(10.0%vs.28.0%,P<0.05)。结论基于MEWS的标准化急诊预检分诊模式可提升急性胸痛救治效率,改善患者预后。Objective To evaluate the application effect of standardized emergency pre-examination triage mode in emergency chest pain patients.Methods A total of 50 patients with acute chest pain admitted to the department of emergency,East Hospital,Quanzhou First Hospital,Fujian from February to May 2023 were selected as the control group,and 50 patients with acute chest pain admitted to department of emergency,East Hospital,Quanzhou First Hospital,Fujian from June to September 2023 were selected as the study group.The control group adopted the traditional emergency predetection triage method,and the study group adopted the standardized emergency predetection triage model based on the modified early warning score(MEWS).The time of emergency management,the time of first medical contact to balloon opening(FMC-to-B),the time from entrance to balloon opening(D-to-B)and the occurrence of adverse events were compared between the two groups.Results The time of pre-examination triage[(2.2±0.5)min vs.(3.6±1.4)min],the time of first electrocardiogram[(6.1±1.9)min vs.(8.9±2.6)min],the time of bedside detection[(21.4±3.2)min vs.(30.6±6.8)min]and the time of stay in emergency department[(40.2±7.6)min vs.(54.6±11.8)min]in the study group were shorter than those in the control group(P<0.05).FMC-to-B[(50.4±9.3)min vs.(71.3±14.7)min]and D-to-B[(78.6±11.7)min vs.(106.9±15.4)min]in patients with acute coronary syndrome in study group were shorter than those in control group(P<0.05).The cumulative incidence of heart failure,shock and arrhythmia in the study group was lower than that in the control group(10.0%vs.28.0%)(P<0.05).Conclusion Standardized emergency pre-examination triage model based on MEWS can improve the efficiency of acute chest pain treatment and improve the prognosis of patients.

关 键 词：胸痛 急诊 预检分诊 改良早期预警评分系统 效果 预后 

分 类 号：R655[医药卫生—外科学]