急诊胸痛患者就诊流程的分析

Analysis of Medical Treatment Process for Patients with Chest Pain in Emergency Department

目的探讨急诊胸痛诊疗流程的可行性,为进一步改进流程提供依据。方法对某院2016年11月1日-2016年12月31日急诊分诊主诉为"胸痛"及"胸闷"的患者诊疗信息进行回顾性分析。结果胸痛患者973例,占同期急诊内科患者总人次的5.1%。考虑为心源性胸痛占34.1%、肺源性占14.9%、精神神经性占10.4%、胃肠道源性占8.7%、骨骼肌肉占3.0%、未明确诊断占18.3%。就诊等候时间平均5.1分钟,10分钟以内占86.7%。急诊住院率为4.7%,急诊诊治后离院占95.1%。急诊平均滞留时间为3.4小时,其中1小时以内离院患者占55.4%,1小时~6小时以内28.1%,滞留时间6小时以上者占19.1%。结论目前的急诊胸痛流程可以保证患者及时就诊,无危险及低危胸痛患者及时离院,通过动态观察和风险评估,确保患者安全。进一步提出信息化改进措施,以强化急诊胸痛流程的质控管理。

Objective To explore the feasibility of emergency chest pain diagnosis and treatment procedures and provide basis for further improvement of the process. Methods A retrospective analysis was made on the diagnosis and treatment of patients with chest pain and chest tightness from November 1 to December 31, 2016. Results 973 cases of chest pain were reported, accounting for 5.1 percent of total patients.It was considered that the cardiogenic chest pain accounted for 34.1%, pulmonary chest pain was 14.9%, mental neurologic was 10.4%, gastrointestinal source was 8.7%, skeletal muscle was 3.0%, and undefined diagnosis accounted for 18.3%.The average waiting time was 5.1 minutes and 86.7% was in 10 minutes.The emergency hospitalization rate was 4.7 %, and the emergency diagnosis and treatment was 95.1%.The average delay time was 3.4 hours. 55.4% of the patients leave hospital within one hour, 28.1% of patients stay in emergengcy room within 1-6 hours and 19.1% of patients stay more than 6 hours. Conclusion The current emergency chest pain procedure can ensure timely treatment of patients,without danger and low-risk chest pain, timely leave the hospital, and ensure patient safety through dynamic observation and risk assessment.Further information improvement measures to strengthen the quality control management of emergency chest pain procedures.