心电图在社区医疗中的重要作用

目的了解社区医院开展心电图检查的重要作用。方法从堰桥医院7年来进行过心电图检查的患者10483例中选择心电图可以作为确诊依据的急诊患者,包括急性ST段抬高型心肌梗死(STEMI)、阵发性室上性心动过速、阵发性室性心动过速,回顾性分析患者转院情况、治疗情况、转归、诊治费用等。结果 STEMI 107例,其中71例主动选择转上级医院治疗,36例选择在本院进行溶栓治疗,再通26例,平均住院费用为(6058.7±1085.6)元,10例未再通者转上级医院治疗。阵发性室上性心动过速18例患者26次发作,其中23次发作在本院成功终止,另外3次发作转上级医院处理。阵发性室性心动过速7例患者7次发作,其中6次发作在本院成功终止,另外1次发作转上级医院处理。在本院门诊成功治疗的29例次心动过速患者,平均费用为(145.4±65.7)元。结论社区医院开展心电图提高了医院在心血管急症方面的诊治水平、加强了患者对医院的信任、增加了医院的经济效益、稳定了社区医师队伍,急诊患者就近就医减少了病情延误,医疗费用更低廉。社区医院加大投入对贯彻落实了国家小病进社区的医改政策有显著的促进作用。

Objective To investigate the important effect of electrocardiogram （ECG） in community hospitals. Methods 107 patients of acute ST-elevation myocardial infarction （STEMI）, 18 patients of paroxysmal supraventricular tachycardia （PSVT） and 7 patients of paroxysmal ventricular tachycardia （PVT） were selected from 10483 patients who accepted ECG check in our hospital. The dates of hospitalization, therapy, therapeutic effect, treatment costs of all patients were analysised. Results In 107 STEMI patients, 71 patients requested hospital referral, 36 patients choosed thrombolysis in our hospital and the criminal artery recanalization happened to 26 patients, the average cost of hospitalization of 26 patients were （6058.7±1085.6） yuan, 10 patients whose thrombolysis failed accepted hospital referral. 26 PSVT took place in 18 patients, and 23 PSVT were terminated in our hospital, another 3 patients whose PSVT could not be terminated accepted hospital referral.7 PVT took place in 7 patients, and 6 PVT were terminated in our hospital, another 1 patients whose PVT could not be terminated accepted hospital referral. The average cost was （145.4±65.7） yuan in patients whose PSVT and PVT were cured in our hospital. Conclusion To carry out electrocardiogram （ECG） in community hospitals elevates the hospital level to diagnose end therapy cardiovascular emergencies, and enhances patient＇s entrust for hospital, and increases the economic returns of hospital, and stabilizes physicians of Community Hospitals, and reduces delay of illness for emergency patients, and cut down medical care costs. To add investment to community hospitals can promote to carry out medicine policy which encourages patient to receive medical treatment in community hospitals.