某院急性心肌梗死单病种质量控制调查

Research on the Application of Monopathy Quality Control with Acute Myocardial Infarction in Our Hospital

目的:评价某院急性心肌梗死(AMI)单病种质量控制的诊疗水平及临床应用。方法:时该院2009年11月～2011年1月的79例AMI住院患者的9个质量控制指标进行回顾性分析。结果:79例AMI患者住院期间有61例(77.2%)进行了彩色多普勒超声心动图检查;68例(86.1%)进行了血脂评价;急性ST段抬高型心肌梗死(STEMI)患者行急诊PCI的平均就诊-球囊扩张时间为(2.23±2.22)h;溶栓治疗的平均就诊-溶栓时间为1.5 h;到达医院后即刻使用阿司匹林的患者占97.5%;住院期间阿司匹林、β受体阻断药、ACEI/ARB、调脂药物的使用率分别为100%、79.7%、87.3%和97.5%;出院后阿司匹林、β受体阻断药、ACEI/ARB、调脂药物使用率分别为92.1%、72.4%、73.7%、93.4%。对59例(74.7%)患者提供AMI健康教育;平均住院日为10.54 d;平均住院费用为50 023.18元。结论:某院对AMI的诊疗基本符合"急性心肌梗死单病种质量控制指标",而早期再灌注治疗还存在进一步的提高空间。

Objective：To evaluate the level of diagnosis and treatment and the clinical application of monopathy quality control in patients with acute myocardial infarction in our hospital. Methods：A total of 79 patients with acute myo-cardial infarction, who were randomly sampled and had once been diagnosed during November 2009 to January 2011, were analyzed retrospectively about the state of monopathy quality control. Results：A total of 61 AMI patients had received the evaluation of LVEF （left ventricular function tests） and 68 AMI patients had receivedthe assessments of LDL cholesterol. The average time of door to needle in the patients who received thrombolytic therapy was 1.5h, and the average time of door to balloon in the patients with STEMI who received p-PCI therapy was 2.23±2.22 h. The patients who treated with Aspirin immediately after arriving hospital account for 97.5%. The rates of using Aspirin, p-blocker, ACEI/ARB and Stains dur- ing the hospitalization were respectively 100% ,79.7% ,87.3% and 97.5%. The use rates of Aspirin, b-blocker, ACEI/ ARB and Stains, which were prescribed at discharged were 92.1%, 72.4% , 73.7% and 93.4%. There were 59 AMI pa- tients had received the health education at discharge. The average days of hospital stay in AMI patients were 10.54 days while the average cost of treatments was 50 023.18 RMB. Conclusion：The diagnosis and treatments basically met the demands of monopathy quality control in patients with acute myocardial infarction in our hospital, while the early reperfusion therapy needs to be improved.