“社区-急救-医院”联动体系在老年胸痛患者院前急救的应用研究  

Application of“community-emergency-hospital”linkage system in pre-hospital emergency care for elderly chest pain patients

作　　者：何梦娟 孙飞 郑丽君 苟思琪 HE Mengjuan;SUN Fei;ZHENG Lijun;GOU Siqi(Department of Emergency Medicine,Guangyuan First People's Hospital,Guangyuan Sichuan 628017,China)

机构地区：[1]广元市第一人民医院急诊科,四川广元628017

出　　处：《中国急救复苏与灾害医学杂志》2025年第3期281-285,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：2023年度广元市指导性科技计划项目(23ZDYF0075)。

摘　　要：目的探究“社区-急救-医院”联动体系在老年胸痛患者院前急救的应用效果。方法以2023年11月广元市第一人民医院采取“社区-急救-医院”联动体系为分界线,将2023年4月—2023年10月广元市第一人民医院收治的老年胸痛患者归为对照组(采用常规急救干预),将2023年11月—2024年5月四川省广元市第一人民医院收治的老年胸痛患者观察组(采用“社区-急救-医院”联动体系干预),两组均随机抽取各138例患者参与研究,比较两组预检分诊情况、抢救情况、转运情况效率差异,观察两组现场急救效果[呼吸(R)、心率(HR)、血压(BP)、视觉模拟评分法(VAS)],统计两组并发症发生率及死亡情况。结果观察组预检分诊所需时间、预检候诊所需时间、首次心电图所需时间、总急救时间、发病至确诊时间、发病至急救时间、住院时间以及患者的R、HR、收缩压、舒张压均显著低于对照组(t=18.206、16.994、15.542、15.571、16.140、20.721、17.054、4.611、3.413、2.799、3.226,均P<0.05);观察组的转运情况(转运设备与用品、护理评估、转运后交接、沟通和衔接)显著优于对照组(χ^(2)=6.114、7.585、8.710、6.539,均P<0.05)。而两组入院时VAS评分以及并发症发生率(10.14%vs.18.84%)、病死率(2.17%vs.4.35%)比较差异无统计学意义(P>0.05)。结论“社区-急救-医院”联动体系用于老年胸痛患者院前急救,能显著减少预检分诊时间和抢救时间,提高转运效率及抢救结局。Objective To explore the application effect of the“Community-Emergency-Hospital”linkage system in pre-hospital emergency care for elderly patients with chest pain.Methods Taking the implementation of“communityemergency-hospital”linkage system in the hospital in November 2023 as the dividing line,patients with elderly chest pain admitted to our hospital from April to October 2023 were classified as the control group(conventional emergency intervention),while those admitted from November 2023 to May 2024 were categorized as the observation group(intervention under the“community-emergency-hospital”linkage system).138 patients in each group were randomly selected to participate in the study.The differences in efficiency of pre-examination and triage,rescue and transfer were compared between groups.The on-site emergency effects[respiration(R),heart rate(HR),blood pressure(BP),visual analogue scale(VAS)]were observed in both groups.The incidence rates of complications and death in the two groups were counted.Results The time required for pre-examination and triage,the time required for pre-examination and waiting,the time required for the first electrocardiogram,the total first aid time,the time from onset to diagnosis,the time from onset to first aid,the time of hospitalization,and the R,HR,systolic blood pressure and diastolic blood pressure of the patients in the observation group were significantly lower than those in the control group(t=18.206,16.994,15.542,15.571,16.140,20.721,17.054,4.611,3.413,2.799,3.226,all P<0.05);the transport situation(transport equipment and supplies,nursing assessment,handover after transport,communication and cohesion)of the observation group was significantly better than that of the control group(χ^(2)=6.114,7.585,8.710,6.539,all P<0.05).There was no significant difference in VAS score at admission,incidence of complications(10.14%vs.18.84%)and mortality(2.17%vs.4.35%)between the two groups(P>0.05).Conclusion“Community-emergency-hospital”linkage system for pre-hospital

关 键 词：老年人 社区-急救-医院 院前急救 胸痛 应用效果 

分 类 号：R459.7[医药卫生—急诊医学]