院前医疗急救电话指导在急性冠脉综合征患者中的应用效果

Application effect of pre-hospital medical emergency telephone guidance in patients with acute coronary syndrome

目的探讨院前医疗急救电话指导在急性冠脉综合征(ACS)患者中的应用效果。方法选择2017年9月~2018年3月海南省海口市120急救中心(以下简称“我中心”)院前救治的267例ACS患者作为研究对象,其中2017年9~12月我中心救治的129例ACS患者作为对照组,2018年1~3月我中心救治138例ACS患者作为观察组。对照组接急救电话后未进行医疗指导,派遣院前急救人员进行现场检查、治疗和转运,观察组接到急救电话后派遣任务的同时给予电话医疗指导,指导求救者就地抢救。观察两组患者现场救治时间、院前急救人员到达时症状缓解率、家属的院前急救工作满意度及转运到医院前恶性心血管事件发生率。结果两组第一目击者基本资料比较差异无统计学意义(P>0.05)。观察组患者现场救治时间短于对照组(P<0.05),院前急救人员到达时症状缓解率、家属的院前急救满意度高于对照组(P<0.05)。观察组患者转运到医院前恶性心血管事件发生率低于对照组(P<0.05)。结论院前医疗急救电话指导在ACS患者救治中具有一定效果,可一定程度弥补公众院前急救知识的不足。

Objective To explore application effect of pre-hospital medical emergency telephone guidance in patients with acute coronary syndrome(ACS).Methods 267 ACS patients of 120 Emergency Center of Haikou City in Hainan Province ("our center" for short) from September 2017 to March 2018 were selected as the study subjects,129 ACS patients in our center from September to December 2017 as control group,138 ACS patients in our center from January to March 2018 as observation group.Control group did not receive medical guidance after receiving the emergency call,dispatching pre-hospital emergency personnel for on-site inspection,treatment and transshipment,while observation group received the emergency call and dispatched tasks at the same time to give telephone medical guidance to guide the rescuers in-situ rescue.The on-site treatment time,the remission rate of symptoms on arrival of pre-hospital emergency personnel,the satisfaction degree of family members in pre-hospital first aid and the incidence of malignant cardiovascular events before transporting to hospital were observed in two groups.Results There was no significant difference in the basic data of the first witness between two groups (P > 0.05).The time of on-site treatment in observation group was shorter than that in control group (P < 0.05).The remission rate of symptoms and the satisfaction degree of family members in pre-hospital care in observation group were higher than those in control group (P < 0.05).The incidence of malignant cardiovascular events in observation group was lower than that in control group (P < 0.05).Conclusion Pre-hospital medical emergency telephone guidance has a certain effect in the treatment of patients with acute coronary syndrome,which can make up for the lack of pre-hospital first aid knowledge to a certain extent.