基层医院胸痛中心建立对STEMI患者直接入导管室行PCI治疗的护理效果分析

Nursing effect analysis of establishment of chest pain centers in primary hospital on treatment of STEMI patients undergoing direct percutaneous coronary intervention directly into the catheterization room

目的总结基层医院胸痛中心成立后对急性ST段抬高型心肌梗死(STEMI)患者行直接经皮冠状动脉介入(PCI)的护理效果。方法选取2017年12月—2018年12月本院成立胸痛中心后收治的162例STEMI患者作为观察组,选取2017年1月—2017年11月未成立胸痛中心时收治的131例STEMI患者作为对照组,研究患者临床资料,分析两组患者首份心电图时间、床旁肌钙蛋白T(TNT)时间、激活导管室时间、家属签字同意时间、门球时间(door-to-balloon,D-to-B)、住院用时、人均住院费用、住院病死率以及护理不良事件发生率的差异。结果对照组首份心电图时间为(12.90±2.34)min、床旁TNT时间为(27.37±3.91)min、激活导管室时间为(26.35±2.46)min、家属签字同意时间为(48.44±7.80)min、门球时间为(116.20±42.62)min;观察组首份心电图时间为(3.86±0.49)min、床旁TNT时间为(16.80±2.11)min、激活导管室时间为(17.67±2.38)min、家属签字同意时间为(30.06±4.70)min、门球时间为(69.95±16.36)min;两组观察指标相比,差异有统计学意义(P<0.05)。对照组住院用时(10.64±4.09)天、人均住院费用(43407.00±544.00)元、住院病死率(7.63%)以及护理不良事件发生率(6.87%)与观察组住院用时(7.77±3.06)天、人均住院费用(36425.00±370.00)元、住院病死率(1.85%)以及护理不良事件发生率(1.23%)相比,有统计学意义(P<0.05)。结论基层医院胸痛中心建设可减少激活导管室时间和家属签字同意时间,缩短D-to-B时间和住院用时,减少人均住院费用,降低住院死亡率以及护理不良事件发生率,值得基层医院推广和应用。

Objective To summarize nursing effect analysis of establishment of chest pain centers in primary hospital on treatment of ST-segment elevation myocardial infarction(STEMI) patients undergoing direct percutaneous coronary intervention(PCI) directly into the catheterization room.Methods A total of 162 patients admitted to our hospital from December 2017 to December 2018 after the establishment of the chest pain center were selected as the observation group;at the same time, 131 patients admitted to our hospital from January 2017 to November 2017 before the establishment of the chest pain center were selected as the control group.The time for the first Electrocardiogram(ECG),time for bedside TNT,time for activating the catheter chamber, time for family members to sign up, time for door-to-balloon(D-to-B),time spent in hospital, per capita hospitalization cost, hospital fatality rate, and incidence of nursing adverse events were compared between two groups.Results The time of the first ECG in the control group was(12.90±2.34) min, the time of bedside TNT was(27.37±3.91) min, the time of activation of the catheter was(26.35±2.46) min, the time of family members′ signature was(48.44±7.80) min, the time of D-to-B was(116.20±42.62) min;and the time of the first ECG in the observation group was(3.86±0.49) min, the time of bedside TNT was(16.80±2.11) min, and the time of activation of the catheter was(17.67±2.38) min.The time for family members to sign the agreement was(30.06±4.70) min, and the time for D-to-B was(69.95±16.36) min;the difference between the two groups were statiscally significant(P< 0.05).The hospitalization duration(10.64±4.09) days, per capita hospitalization expense(43407.00±544.00) yuan, inpatient mortality(7.63%),and nursing adverse event incidence(6.87%) in the control group were statistically significant(P< 0.05)compared with the observation group.Conclusion The construction of chest pain centers in primary hospitals can reduce the time of activation of catheterization rooms and the time for family members to sign their consent, shorten D-to-B time and hospitalization time, reduce per capita hospitalization expenses, reduce inpatient mortality and the incidence of nursing adverse events, and is worthy of promotion and application in primary hospitals.