胸痛中心区域协同救治微信群对ST段抬高型心肌梗死患者PCI急救效率的影响

Effect of combined treatment by We Chat group of doctors of of chest pain on PCI treatment time routine of STEMI patients

目的探讨胸痛中心区域协同救治微信群对ST段抬高型心肌梗死(ST elevation myocardial infarction,STEMI)患者经皮冠状动脉介入治疗(Percutaneous Coronary Intervention,PCI)急救效率的影响.方法以汕尾市第二人民医院为核心,以汕尾市不具备PCI能力的各县区医院及乡镇卫生院急诊医师、心内科医师为成员,建立"胸痛中心区域协同救治"微信群.择取2018-01至2019-04由其他医院转诊至汕尾市第二人民医院的STEMI患者92例为研究对象,以微信群建立后入组的46例为观察组,使用微信群前入组的46例为对照组,比较观察两组PCI治疗各环节时间差异与术后终点不良事件发生率.结果两组转运时间基本相当,但观察组诊断及初治时间、签署知情同意书时间、启动导管室时间、第二人民医院接诊至球囊扩张时间、发病至接受PCI总时间均早于对照组,差异有统计学意义(P<0.05).结论胸痛中心区域协同救治微信群的建立可以有效缩短不具备PCI能力的县区医院及乡镇卫生院收治的STEMI患者的PCI急诊救治时间,对挽救患者生命、改善预后、减少终点不良事件具有积极作用,值得推广使用.

Objective To explore the effect of combined treatment by WeChat group of doctors of the central area of chest pain on PCI treatment time routine of STEMI patients. Methods With the Second People's Hospital of Shanwei as the core, we set up a WeChat group of emergency doctors and cardiologists in counties and district hospitals and township hospitals that do not have PCI capability in Shanwei City. 92 STEMI patients who were transferred from other hospitals to the Second people's Hospital of Shanwei City from January 2018 to April 2019 were selected as the study objects. 46 patients who entered the group after the establishment of Wechat group were taken as the observation group, and 46 patients who entered the group before the setup of Wechat group were taken as the control group. The time differences and the incidence of adverse events at the end of PCI treatment were compared between the two groups. Results The transit time of the two groups was basically equivalent, but the observation group's diagnosis and initial treatment time, the time of signing the informed consent form, the time of starting the catheter room, the time from the second people's hospital to the balloon expansion time, and the total time from onset to PCI were earlier than the control group. The difference was statistically significant (P<0.05). Conclusions The establishment of the Collaborative Treatment WeChat group for the central area of chest pain can effectively shorten the PCI emergency treatment time for STEMI who were patients admitted to county hospitals and township hospitals without PCI ability. It is worth promoting and has a positive effect on saving patients' lives, improving prognosis and reducing end-point adverse events.