胸痛中心网络医院转诊急性ST段抬高型心肌梗死患者的救治体会

Experience in the treatment of patients with acute ST-segment elevation myocardial infarction referred by chest pain center network hospital

目的研究网络医院转诊急性ST段抬高型心肌梗死患者的救治情况。方法选取2018年9月~2019年8月汕尾市第二人民医院胸痛中心网络医院转诊的急性STEMI患者111例,按时间顺序分为胸痛中心建设前组及胸痛中心建设后组,比较两组患者的救治情况。结果两组患者进入首诊医院到转出时间、院内心衰发病率、院内病死率比较,差异无统计学意义(P>0.05)。建设后组入门至导丝通过时间、绕行急诊比例、直接PCI比例与建设前组比较,差异有统计学意义(P<0.05)。结论胸痛中心区域协同救治体系的建设,网络医院转诊急性STEMI患者明显增加,救治效率提高。但网络医院的救治时间因各种因素并未明显改善,需要注重胸痛中心区域协同救治体系的质量持续改进工作。

Objective To study the treatment of patients with acute ST-segment elevation myocardial infarction referred by network hospital.Methods 111 patients with acute STEMI referred by chest pain center network hospital of the Second People’s Hospital of Shanwei from September 2018 to August 2019 were selected,and divided into the pre-construction group of chest pain center and the post-construction group of chest pain center in chronological order.The treatment of patients was compared between the two groups.Results There was no significant difference in the time from admission to the first diagnosed hospital to referral,incidence of hospital heart failure,and hospital mortality between the two groups of patients(P>0.05).There were statistically significant differences in the time from entry to guide wire passage,proportion of detour emergency,and proportion of direct PCI between the post-construction group and the pre-construction group(P<0.05).Conclusion The establishment of a regional collaborative treatment system for chest pain center contributes to a significant increase in patients with acute STEMI referred by network hospital,and enhanced treatment efficiency.However,the treatment time of network hospital has not been significantly improved due to various factors,and thus it is necessary to pay attention to the continuous improvement of the quality of the regional collaborative treatment system for chest pain center.