胸痛微信群在急性ST段抬高型心肌梗死诊疗中的应用

Application of chest pain WECHAT Group in the diagnosis and treatment of ST-segment elevation myocardial infarction

目的评估胸痛微信群对急性ST段抬高型心肌梗死(STEMI)诊疗的影响。方法 2015年5月建立胸痛微信群。选择2015年5月至2016年4月经本院确诊STEMI的患者30例作为观察组,由首诊医师床边心电图检查、并上传至2015年5月建立的胸痛微信群,心内科医师网上会诊,确诊为STEMI后立即启动绿色通道,行急诊经皮冠状动脉介入治疗(PCI)。选择2013年5月至2015年4月本院急诊PCI的30例STEMI患者为对照组。比较两组患者入门到导管室时间(术前时间),导管室内至血管再灌注时间(手术时间),入门到球囊扩张时间(D-B时间),90和120min再灌注率。结果观察组术前时间(76.46±29.04)min和D-B时间(97.40±29.84)min均显著低于对照组(109.21±49.16)min和(134.56±49.01)min(均P<0.05)。120min再灌注率观察组(83.33%)显著高于对照组(40.00%),差异有统计学意义(χ2=11.92,P<0.05),观察组手术时间和90min再灌注率[(21.26±6.06)min,36.67%]与对照组接近[(25.36±9.68)min,20.00%]。结论应用胸痛微信群能明显缩短术前时间、D-B时间、提高120min再灌注率。

Objective To investigate the application of chest pain WECHAT Group in the diagnosis and treatment of ST-segment elevation myocardial infarction(STEMI).Methods A chest pain WECHAT Group was established at May2015.30patients underwent emergency percutaneous coronary intervention(PCI)from May2015to April2016,were enrolled as observation group.A bedside electrocardiogram was recorded in all patients and uploaded to chest pain WECHAT Group by the first contact physician and consulted with cardiologists on line.As soon as STEMI was determined the green channel was opened and PCI was performed.The times from first medical contact to cath lab arrival(pre-operation time)and from cath lab arrival to reperfusion(operation time),door-to-balloon time,reperfusion rate at90minutes and120minutes were recorded and compared with30STEMI patients underwent PCI fromMay2013to April2015(control group).Results The pre-operation time and door-to-balloon time were significantly shorter,reperfusion rate at120minutes were significantly higher in observation group than control group[(76.46±29.04)min,(97.40±29.84)min,83.33%vs(109.21±49.16)min,(134.56±49.01)min,40%,respectively,all P<0.05].The operation time and reperfusion rate at90minutes were not significantly different between two groups[(21.26±6.06)min,36.67%vs(25.36±9.68)min,20%,respectively].Conclusion Application of chest pain Wechat Group can shorten pre-operation time,door-to-balloon time and improve reperfusion rate at120minutes.