优化介入流程对急性心肌梗死患者开通血管时间及左室功能的影响

Effects of Optimized Intervention Process on Opening of Blood Vessel Time and Left Ventricular Function in Patients with Acute Myocardial Infarction

目的探讨优化介入流程对急性ST段抬高型心肌梗死(STEMI)患者PCI治疗血管再通时间及左室功能的影响.方法选择215例行急诊经皮冠状动脉介入(PCI)治疗并完成6个月随访的STEMI的患者,按照优化介入流程启动时间顺序分为两组.记录两组患者靶血管病变、心功能Killip分级,比较两组患者Dt B时间、平均住院日、住院总费用、入院和PCI术后6个月左室射血分数(LVEF)变化值及术后6个月死亡情况.结果两组患者基本情况、靶血管病变、心功能Killip分级等比较差异无统计学意义(P>0.05);观察组入门-球囊扩张时间、平均住院日、住院总费用均低于对照组,差异具有统计学意义(P<0.05);两组患者入院时LVEF相似,但在PCI术后6个月随访时左室射血分数变化值高于对照组(P<0.05).结论单病种质量管理可缩短STEMI患者急诊PCI入门-球囊扩张时间,减少平均住院日及住院费用,改善术后6个月左心室功能.

Objective To investigate the optimized intervention process on recanalization time and left ventricular function of PCI treatment in patients with acute ST segment elevation myocardial infarction（ STEMI）.Method A total of 215 patients with STEMI who underwent percutaneous coronary intervention（ PCI） were enrolled in this study. After six months of follow-up,the patients were divided into two groups according to the starting time of the treatment process. The target vessel lesion and Killip grade of cardiac function were recorded in the two groups. The Dt B time,average hospitalization days,total hospitalization expenses,change value of left ventricular injection fraction（ LVEF）,and deaths within six months after surgery were compared between the two groups. Results There was no significant difference in basic situation,target vessel lesion,and Killip grade of heart function between the two groups（ P 0. 05）. The door-to-balloon time,average hospitalization days,hospitalization expenses of the observation group were lower than those of the control group（ P 0. 05）. Whenthey were admitted,the LVEF of the two groups were similar. But the change value of LVEF in the observation group was significantly higher than that in the control group after six months of postoperative follow-up（ P 0. 05）. Conclusion Single disease quality management can shorten the door-to-balloon time in patients with STEMI in the emergency of PCI,reduce average hospitalization days and hospitalization expenses,and improve left ventricular function within 6 months after surgery.