目标导向的多学科合作诊疗模式在急性心肌梗死急救中应用

Application of Goal-oriented Multi-disciplinary Cooperative Diagnosis and Treatment Model in the First Aid Treatment of Acute Myocardial Infarction

目的:探索目标导向的多学科合作诊疗模式在急性心肌梗死急救中应用价值,提升ST段抬高心肌梗死的救治能力.方法:专家头脑风暴法创建目标导向的多学科合作诊疗模式及质量控制标准,通过目标导向的多学科合作诊疗模式救治ST段抬高心肌梗死患者,整合相关专业医疗质量控制指标进行评估.对比研究目标导向的多学科合作诊疗模式建立前后急性心肌梗死的急救能力,评估该模式的功效性.结果:通过目标导向的多学科合作诊疗模式救治ST段抬高心肌梗死患者,对照组患者186例,实验组173例,两组在发病年龄、男女比例、合并基础疾病上比较无明显差异,无统计学意义(P>0.05);两组在救治时效性、随访30天内的终点事件及平均住院时间上比较,差异有统计学意义(P<0.05).结论:急性心肌梗死患者从院前急救开始到急诊再灌注治疗,以急性心肌梗死患者急救需要为目标、为导向,由急诊科、心内科提供具有时效性与高效性的无缝服务.明显提高了急性心肌梗死急救的时效性与高效性.

Objective： To investigate the application value of goal-oriented multi-disciplinary cooperative diagnosis and treatment model in acute myocardial infarction, and to improve the rescuing ability for patients with ST segment elevation myocardial infarction. Methods： Applying expert brainstorming method to create the goal-oriented multi-disciplinary cooperative diagnosis and treatment model and quality control standards. The model was used to treat myocardial infarction patients with ST segment elevation, and to assess the integrated related medical quality control indexes. The efficacy of this model was evaluated by comparing the first-aid ability for acute myocardial in- farction before and after founding the model. Results： Patients with ST segment elevation myocardial infarction in the control group were186 cases, in the experimental group were173 cases, and the experimental group was treated with target-oriented multi-disciplinary cooperative diagnosis and treatment model. The onset age, sex ratio and combined underlying disease of two groups was not statistically significant （P〉O.05）. But the outcome within 30 days of fol- low-up, average hospitalization time of two groups was statistically significant （P〈0.05）. Conclusion： For patients with acute myocardial infarction from pre-hospital rescue to emergency reperfusion therapy, taking the emergency needs of patients with acute myocardial infarction as the goal and the guide, the emergency department and the car- diology department provide timely, efficient and seamless service. It obviously improves the timeliness and effective-ness of first aid for acute myocardial infarction.