“一键式启动导管室”在急性心肌梗死直接PCI中的应用研究

Application of one-button starting catheterization during primary percutaneous coronary intervention in patients with acute myocardial infarction

目的分析一键式启动导管室建立前后直接经皮冠状动脉介入术（PCI）过程中主要指标的变化情况。方法选取2014年1-6月和2015年1-6月一键式启动导管室建立前后在成都军区昆明总医院心血管内科序贯住院行直接PCI的急性心肌梗死患者,回顾分析主要指标包括导管室启动时间和＂门球＂（D2B）时间,次要指标包括绕行急诊科和冠心病重症监护室（CCU）比例,患者死亡率。统计分析两组数据的变化情况。结果 2014年1-6月间与2015年1-6月间收治患者年龄、性别构成、合并疾病无统计学差异（P〉0.05）。2014年1-6月导管室启动时间（33.3±12.1）min和D2B时间（104.4±24.8）min显著长于2015年1-6月导管室启动时间（15.8±6.2）min（P〈0.05）和D2B时间（60.6±15.3）min（P〈0.05）。2014年1-6月绕行急诊科和CCU比例显著低于2015年1-6月,而死亡率高于2015年1-6月（P〈0.05）。结论一键式启动导管室显著降低了导管室启动时间,带来了D2B时间的降低,让急性心肌梗死患者获益。

Objective To analyze the changes of major indexes before and after the establishment of one-button starting catheterization in patients with acute myocardial infarction （AMI） during percutaneous coronary intervention （PCI）. Methods AMI patients undergone PCI before and after the establishment of one-button starting catheterization were chosen from Jun. 2014 to Jun. 2014 （group 1） and from Jun. 2015 to Jun. 2015 （group 2）. The major indexes including catheterization starting time and door to balloon （D2B） time, and secondary indexes including percentages of bypass the emergency department and CCU and mortality were retrospectively analyzed. The changes of all indexes were analyzed in 2 groups. Results The compositions of age and sex and complicated diseases had no statistical difference between 2 groups （P〉0.05）. The catheterization starting time [（33.3±12.1） min vs. （15.8±6.2） mini and D2B time [（104.4±24.8） rain vs. （60.6±15.3） mini were significantly longer in group 1 than those in group 2 （P〈0.05）. The percentage of bypass the emergency department and CCU was significantly lower, but mortality was higher in group 1 than that in group 2 （P〈0.05）. Conclusion One-button starting catheterization can reduce significantly catheterization starting time and D2B time, which is benefit for AMI patients.