“微信群”在急性心肌梗死无缝隙转诊行急诊PCI手术中的运用价值

The value of “We Chat group” in acute myocardial infarction patients about using seamless referral and the emergency treatment

目的探讨一种全新沟通方式“微信群”在急性心肌梗死患者转诊行急诊冠脉介入手术中的运用价值。方法选取2014年1月-2014年12月从基层医院转诊嘉兴市第一医院行急诊冠脉介入手术的患者作为研究对象，按转诊时是否有相关诊疗信息（病史、心电图、实验室检查等）及时上传嘉兴市第一医院“微信群”，将患者分为微信组46例和对照组40例，观察2组的急性心肌梗死标准化抢救流程的完成率及主要心血管并发症的发生率。结果微信组在心电图完成率、术前药物服用率与对照组比较，差异无统计学意义（χ^2=1．16、2．35，P〉0．05），在术前手续完成率、急诊手术送达率、90min内闭塞血管开通率明显高于对照组，差异有统计学意义（χ^2=5．27、5．47、6．61，P〈0．05）；微信组发生主要心血管并发症发生率明显低于对照组，差异有统计学意义（χ^2=4．45，P〈0．05）。微信组发生心脏性死亡2例，对照组发生7例，2组比较差异有统计学意义（χ^2=3．94，P〈0．05）。结论“微信群”作为一种全新的沟通方式，其快速、便捷、高效的特点可以明显提高沟通效率。在急性心肌梗死转诊行急诊冠脉介入手术过程中，可以明显缩短术前准备时间，提高转诊患者标准化抢救流程的完成率，提高抢救成功率，值得推广应用。

Objective To explore the value of a new way of communication＂ WeChat group＂ in patients with acute myocardial infarction in the surgical referral. Methods According to whether the related medical information timely upload to WeChat group, we divided acute myocardial infarction patients with emergent PCI as WeChat group and control group from the grass-roots hospitals from January to December 2014, which WeChat group 46 cases, control group 40 cases. And we observed standard rescue process completion rate and the occurrence rate of major cardiovascular complications in two groups. Results There was no significant difference in ECG completion rate and preoperative medications in two groups. But it was significantly higher in WeChat group in preoperative procedures completion rate, emergency operation delivery rate and occlusive vascular patency rate than those of the control group, and the difference were statistically significant （χ^2= 5.27,5.47,6.61, P 〈 0.05 ） ; The major cardiovascular complications incidence in WeChat group occurred was significantly lower than that of the control group, and the difference was statistically significant （χ^2= 4.45, P 〈 0. 05 ）. The sudden cardiac death occurred in WeChat group and control group were 2 cases and 7 cases, respectively, and there was significant difference between two groups （ χ^2= 3.94,P 〈 0.05 ）. Conclusion As a new way of communication, WeChat has the characteristics of fast, convenient and efficient, can significantly improve the efficiency of communication, and can significantly improve the completion rate of referral of patients with acute myocardial infarction standardization process, improve the success rate, and it is worthy of popularization and application.