急诊肺栓塞患者诊疗抢救时间现况及相关性分析

The analysis of current status and correlation of emergency treatment for patients with acute pulmonary embolism

目的探讨急诊肺栓塞患者就诊各个阶段时长情况及各阶段时长之间的相关性,在此基础上提出切实可行的优化策略。方法对我院2015年8月至2017年8月在急诊就诊的肺栓塞患者基本资料、发病时间、就诊时间、入抢时间、住院时间进行调查分析,重点查看各阶段时长之间的相关性与原因分析,实施针对性护理或管理措施,以期提高急诊肺栓塞患者的救治效果并缩短住院时间。结果肺栓塞患者临床症状表现为呼吸困难、头晕、胸闷和意识障碍,大多合并高血压病、糖尿病、高脂血症和下肢深静脉血栓。肺栓塞患者的症状-分诊期与分诊-入抢期、抢救室滞留期时长呈负相关(P<0.05),症状-分诊期与住院期无相关性(P>0.05);分诊-入抢期与抢救室滞留期、住院期呈正相关(P<0.05);抢救室滞留期与住院期呈正相关(P<0.05)。结论提高肺栓塞的全民健康管理意识,建立院前-院中-院后的闭环式健康管理模式,院前做好预防,发现症状及时就诊,缩短院前延误时间。院内构建急诊肺栓塞患者的绿色通道,其中包括提高分诊准确率与诊断及时性,缩短检验、检查、缴费各环节的等待时间。

Objective To explore the current status of duration in each stage of treatment among patients with acute pulmonary embolism and the correlation between these durations.On the basis of this,we put out the feasible optimization strategy.Methods The basic data,onset time,visit time,time of admission,and length of hospitalization of patients with pulmonary embolism who were admitted to the emergency department of our hospital from August 2015 to August 2017 were investigated and analyzed.The causes and correlation between the durations of each stage was analyzed specifically.Then targeted nursing or management was implemented for this to improve the treatment effect of patients with emergency pulmonary embolism and shorten the length of hospital stay.Results The clinical symptoms of patients with pulmonary embolism included dyspnea,dizziness,chest tightness and disturbance of consciousness.Most of them also had hypertension,diabetes,hyperlipidemia and deep vein thrombosis of lower extremities.There was negative correlation among symptoms,the period of symptoms to triage diagnosis,period of triage diagnosis to rescue,and time of detention in the emergency room of patients with pulmonary embolism(P<0.05).There was no correlation between period of symptoms to triage diagnosis and the hospitalization period(P>0.05).There was positive correlation between the period of triage to rescue,time of detention in the emergency room,and the hospitalization(P<0.05).There was positive correlation between time of detention in the emergency room and the hospitalization(P<0.05).Conclusion We should improve the national health management awareness of pulmonary embolism and establish a closed-loop health management model including pre-hospital,in-hospital and post-hospital periods.During the pre-hospital time,we should provide effective prevent precautions.If the patients find symptoms,they can come to hospital as soon as possible,thus shorten the pre-hospital delay.In the hospital,we should build green channel for patients with pulmonary embolism in emergency department,including the improvement of accuracy and timeliness of triage diagnosis,and shortening the waiting time for testing,inspection,and payment.