城乡对口支援对北川羌族自治县急性ST段抬高型心肌梗死区域协同救治诊治及预后的影响

The effect of implementing counterpart support between urban and rural hospitals on patients with acute ST segment elevation myocardial infarction in regional cooperative rescue of Beichuan qiang minority autonomous county

目的探讨城乡对口支援对急性ST段抬高型心肌梗死区域协同救治诊治及预后的影响。方法绵阳市中心医院2016年9月起对北川羌族自治县人民医院进行医疗对口支援活动。选择2016年3月—2017年2月绵阳市北川羌族自治县人民医院转院至绵阳市中心医院行急诊PCI的急性ST段抬高型心肌梗死患者49例,按对口支援前后分组,对2组患者危险因素、转院前药物使用情况、诊治过程中重要时间节点及预后进行比较。结果 49例急性ST段抬高心肌梗死患者中,对口支援后,急性ST段抬高型心肌梗死患者转院前低分子肝素、他汀类使用率明显提高(P<0.05),诊治过程中决定其预后的重要的时间节点显著缩短,患者c Tn T的达峰提前(P<0.05),峰值明显降低(P<0.01),院内心力衰竭、病死率显著下降(P<0.05)。结论城乡对口支援提高了当地急性ST段抬高型心肌梗死患者的诊断率和治疗规范性,通过对口支援期间区域协同化救治的实施,缩短患者的救治时间,挽救了濒死的心肌,改善了患者的预后。

Objective To evaluate the effect of counterpart support between urban and rural hospitals on regional cooperative rescue of acute ST segment elevation myocardial infarction.Methods Department of Cardiology, Mianyang, central hospital lauched medical support program for Beichuan qiang autonomous county people＇s hospital in September 2016. A total of 49 SETMI patients adimitted to Beichuan qiang autonomous county people＇s hospital referred to the Mianyang central hospital for emergency PCI during March 2016 and February 2017 were enrolled. Those patients were allocated to two groups on the time node of September 2016. The risk factors, important drug usage before the transfer, time node and prognosis were analyzed. Results Among the 49 STEMI patients, the usage rate of low molecular heparin, statins after the support program were increased significantly （P〈0.05）.The important time nodes were significantly shortened. After the counterpart support between urban and rural hospitals, The values of cTnT in STEMI patinets reached peak in advance （P〈0.05）, and the peak is decreased obviously （P〈0.01） ,the incidence of heart failure, mortality decreased significantly （P〈0.05）.Conclusions Medical support program improves the rates of diagnosis and standardized treatment of STEMI. The regional cooperative rescue model during medical support program can shorten the patient＇s treatment time, save the frequency dead heart muscle, improve the prognosis of the patients.