ST段抬高型心肌梗死再灌注患者基于时刻APP的救治流程改进

Improvement of treatment process based on time-point APP for patients after reperfusion of ST elevation myocardial infarction

目的探讨时刻APP对ST段抬高型心肌梗死(STEMI)患者再灌注救治流程的优化作用。方法根据就诊时间将中国胸痛中心认证数据管理云平台收录的急诊就诊STEMI患者分为对照组(n=19)和观察组(n=23)。对照组按胸痛中心原流程救治,并通过填写胸痛中心急性胸痛诊治时间节点记录表录入D2B时间。观察组采取以时刻APP分析为指导的改进流程进行救治,并通过时刻APP录入D2B时间。结果流程改进后,观察组从诊断到启动导管室和导管室激活到患者到达2个时间段达标率显著优于对照组(均P<0.01),患者D2B时间的总达标率高于对照组(P<0.05)。结论以时刻APP为指导的救治流程改进可以提高胸痛中心STEMI患者D2B时间达标率,进而改善患者预后。

Objective To explore the improvement effect of time-point APP on reperfusion treatment process for patients with ST elevation myocardial infarction（STEMI）.Methods Totally 42 patients with STEMI for emergency treatment in China Chest pain Center Certified Data Management Cloud were divided into a control group（n=19）and an observation group（n=23）chronologically.The control group was treated according to the original chest pain central procedure,and the D2B time was recorded by filling in the time record of acute chest pain diagnosis and treatment center of chest pain.While the observation group took the improved process guided by the time-point APP analysis for treatment,and entered the D2B time through the time-point APP.Results After process improvement,the compliance rate of the 2 time periods from diagnosis to activation of the catheterization room and the activation of the catheterization room to the arrival of patients in the observation group were significantly better than the control group（P〈0.01 for both）,and the total compliance rate of patients′ D2B time was significantly higher than the control group（P〈0.05）.Conclusion The improvement of the treatment procedure guided by time-point APP can enhance the D2B time compliance rate for STEMI patients in chest pain center,then improve patients′prognosis.