基层医院胸痛中心模式对急性ST段抬高型心肌梗死患者救治效果和预后的影响

Influence of chest pain center treatment modes in primary hospitals on the treatment effects and prognosis of STEMI patients

目的观察基层医院胸痛中心模式对急性ST段抬高型心肌梗死(ST segment elevation myocardial infarction,STEMI)患者救治效果和预后的影响。方法选取2019-04至2019-12清远市清新区人民医院收治的60例STEMI患者作为观察组,选取2018-01至2019-03清远市清新区人民医院收治的40例STEMI患者作为对照组。对照组采用常规模式救治,观察组采用胸痛中心模式救治,比较两组入院后首份心电图完成时间、心肌肌钙蛋白I(cardiac troponin I,cTnI)检测时间及成功行经皮冠状动脉介入术(percutaneous coronary intervention,PCI)患者所占比例、进门-球囊扩张(door-to-balloon,D-to-B)时间、急诊科滞留时间及成功行PCI患者术后1周心脏不良事件发生率。结果观察组首份心电图完成时间、D-to-B时间、cTnI检测时间、急诊科滞留时间均明显短于对照组,差异均有统计学意义(P<0.05);观察组成功行PCI患者比例明显高于对照组,成功行PCI患者住院期间心脏不良事件发生率明显低于对照组,差异均有统计学意义(P<0.05)。结论基层医院胸痛中心模式应用于STEMI患者,可以缩短救治时间,提高PCI救治率,降低PCI后心脏不良事件发生率的效果优于常规救治模式。

Objective To observe influence of chest pain center treatment modes in primary hospitals on the treatment effects and prognosis of patients with acute ST segment elevation myocardial infarction(STEMI).Methods 60 STEMI patients admitted to Qingyuan Qingxin District People's Hospital from April 2019 to December 2019 were selected as the observation group,and 40 STEMI patients admitted to the same hospital from January 2018 to March 2019 were selected as the control group.The control group was treated with conventional mode,while the observation group was treated with chest pain center treatment mode.Then,the first ECG completion time and cardiac troponin I(cTnI)detection time after admission,the proportion of patients underwent percutaneous coronary intervention(PCI),door-to-balloon time(D-to-B time),emergency department residence time,and incidence of adverse cardiac events of successful PCI patients 1 week after the surgery were compared between the two groups.Results The D-to-B time,cTnI detection time and emergency department residence time in the observation group were significantly shorter than those in the control group,and the differences were statistically significant(P<0.05).Further,the proportion of successful PCI patients in the observation group was significantly higher than that in the control group,the incidence of adverse cardiac events of successful PCI patients 1 week during hospitalization was significantly lower than that in the control group,and the differences were statistically significant(P<0.05).Conclusions The chest pain center mode in the primary hospitals applied to the STEMI patients can shorten the treatment time,increase the rate of PCI treatment,and reduce the incidence of adverse cardiac events after PCI.Moreover,it is superior to simple conventional treatment mode.