胸痛中心建设对直接经皮冠脉介入治疗STEMI患者救治及预后的影响

Influence of chest pain center construction on treatment and prognosis of STEMI patients undergoing direct percutaneous coronary intervention

目的探索研究胸痛中心建设对直接经皮冠脉介入治疗ST段抬高型心肌梗死(STEMI)患者救治及预后的影响。方法研究纳入2014年7月-2018年6月我院共收治的518例行直接经皮冠状动脉介入治疗(PPCI)的STEMT患者,以2016年7月-2018年6月我院通过中国胸痛中心论证2年后收治的315例行PPIC术的STEMI患者为观察组,2014年7月-2016年6月通过中国胸痛中心论证2年前收治的203例PPCI的STEMT患者为对照组,研究患者临床资料,分析两组患者门-球时间(door-to-balloon,D-to-B)、人均住院费用、人均药品费用、住院时间、D-to-B达标率、住院死亡率、药占比和心力衰竭发生率。结果对照组D-to-B为(119.78±65.7)min,人均住院费用为(40987.32±17501.35)元,人均药品费用为(7694.64±1105.25)和住院时间为(9.03±4.97)d;与观察组的(80.25±41.3)min、(37921.59±12017.47)元,(5835.00±1026.33)元和(7.57±3.85)d相比,差异有统计学意义(P<0.05);对照组D-to-B达标率为73.89%,住院死亡率为3.45%,药占比18.77%和心力衰竭发生率为69.95%;明显逊于观察组的88.57%、2.86%、15.39%和50.16%,差异有统计学意义。结论胸痛中心建设可缩短D-to-B时间和住院时间,减少人均住院费用和人均药品费用,提高D-to-B达标率、降低住院死亡率、药占比和心力衰竭发生率,推广应用价值明显。

Objective To explore the effect of the construction of Chest Pain Center on the treatment and prognosis of patients with ST-segment elevation myocardial infarction(STEMI) with direct percutaneous coronary intervention. Methods A total of 518 patients with direct percutaneous coronary intervention(PPCI) were admitted from July 2014 to June 2018 in our hospital,From July 2016 to June 2018,our hospital passed the Chinese Chest Pain Center to demonstrate that 2 years after the 315 cases of PPIC STEMI patients were observed group,July 2014 to June 2016 through the Chinese Chest Pain Center demonstrated 2 years ago,203 patients treated by the PPCI of STEMT patients as the control group,we studied the clinical data of the patients,analyzed two groups of patients ’ gate-ball Time(Door-to-balloon,D-to-B),per capita hospitalization cost,per capita drug cost,hospitalization time,D-to-B rate,hospitalization mortality,drug account ratio and heart failure. Results The control group D-to-B(119.78±65.7)min,the per capita hospitalization cost(40987.32±17501.35),the per capita drug cost(7694.64±1105.25) and the length of hospital stay(9.03±4.97)d;(80.25±41.3)min,(37921.59±12017.47) yuan,(5835.00±1026.33) yuan and(7.57±3.85)d compared with statistically significant difference(P05);control group D-to-b compliance rate of 73.89%,Hospitalization mortality was 3.45%,drug accounted for 18.77% and heart failure were 69.95%,significantly worse than 88.57%,2.86%,15.39% and 50.16% in the observation group,the difference was statistically significant. Conclusion The construction of Chest pain Center can shorten d-to-b time and hospitalization time,reduce per capita hospitalization cost and per capita drug cost,improve D-to-B rate,decrease hospitalization mortality,drug account ratio and heart failure incidence,and popularize the application value obviously.