胸痛中心对偏远地区急性ST段抬高心肌梗死患者救治效率的影响

Influence of establishing a chest pain centre on the therapeutic efficiency in ST-elevation myocardial infarction patients in remote area

目的:探讨我院胸痛中心成立初期的运行模式对急性ST段抬高型心肌梗死(ST-elevation myocardial infarction,STEMI)患者救治效率的影响,为进一步优化其建设过程提供依据。方法:回顾性分析新疆维吾尔自治区人民医院心内科行直接经皮冠状动脉介入治疗(PPCI)STEMI患者的病历资料,入选2013-02-01-2014-02-17胸痛中心成立前的135例患者为普通流程组,并选取2014-02-18-2015-03-31胸痛中心成立后的180例患者为胸痛中心组,记录并对比2组患者的一般资料、住院天数、住院花费、总入门-球囊扩张时间(door-to-balloon time,DTBT),并对DTBT各个时间节点进行对比分析。结果:与普通流程组相比,胸痛中心组的DTBT显著缩短,住院天数及住院费用明显减少(均P<0.05),知情谈话时间及转运至动脉穿刺前时间明显缩短(P<0.05)。结论:胸痛中心的成立有助于提升偏远地区STEMI患者的救治效率,缩短再灌注时间,但仍需进一步优化并健全胸痛中心的运行模式,并积极进行区域推广和建设。

Objective：To explore the influence of establishing a chest pain centre（CPC）on therapeutic efficiency in ST-elevation myocardial infarction（STEMI）patients.Method：The data of the PPCI in actue STEMI patients were retrospectively analyzed in our hospital.135 patients were selected as routine team from February 1,2013 to February 17,2014 before CPC established.180 patients were selected as CPC team from February 1,2013 to February 17,2014 after CPC established.We recorded and compared basic data,length of hospital stay,the cost,the door-to-balloon time（DTBT）,and its components between two groups.Result：Compared with routine team,CPC team showed significantly reduced DTBT（P〈0.05）,length of hospital stay,cost（P〈0.05）,time of obtaining informed consent and time from transportation to artery puncture（P〈0.05）.Conclusion：Establishing a chest pain centre is beneficial for promoting therapeutic efficiency and shortening reperfusion time in remote area.But more effort needs to be done for improving the operation mode of CPC and carrying out regional promotion and construction activities.