二级甲等医院胸痛中心建设对急性ST段抬高型心肌梗死的救治探讨与分析

Discussion and analysis of the treatment of acute ST-segment elevation myocardial infarction in the construction of chest pain center in a seccond class hospital

目的探讨胸痛中心建设在救治急性ST段抬高型心肌梗死(STEMI)中的应用效果。方法回顾性分析2019年1—8月(胸痛中心认证前)新余第四医院90例行急诊经皮冠状动脉介入治疗(PPCI)的STEMI患者的临床资料,纳入A组;将2019年9月—2020年5月(胸痛中心认证中)收治的80例STEMI患者的临床资料,纳入B组;将2020年6—12月(胸痛中心认证后)的132例STEMI患者的临床资料,纳入C组。比较三组入院至球囊扩张(D2B)时间,发病至球囊扩张(S2B)时间,院内心衰发生率、病死率,住院时间及费用。结果B组、C组D2B时间短于A组,且C组D2B时间短于B组,差异有统计学意义(P<0.05);三组S2B时间比较,差异无统计学意义(P>0.05);C组、B组住院时间短于A组,住院费用少于A组,差异有统计学意义(P<0.05);C组与B组住院时间及住院费用比较,差异无统计学意义(P>0.05)。三组院内心衰发生率及病死率比较,差异无统计学意义(P>0.05)。结论建立胸痛中心能显著缩短STEMI患者D2B、减少住院费用,值得推广。

Objective To investigate the application effect of chest pain center construction in the treatment of acute ST-segment elevation myocardial infarction(STEMI).Methods The clinical data of 90 STEMI patients who underwent emergency percutaneous coronary intervention(PPCI)in Xinyu Fourth Hospital from January to August 2019(before the certification of chest pain center)were retrospectively analyzed and included in group A.Clinical data of 80 STEMI patients admitted from September 2019 to May 2020(in the certification of chest pain center)were included in group B.Clinical data of 132 STEMI patients from June to December 2020(after chest pain center certification)were included in group C.The door to balloon(D2B)time,the symptom onset to balloon(S2B)time,the incidence of in-hospital heart failure,the mortality rate,the length of hospital stay and the cost of the three groups were compared.Results D2B time in group B and C were shorter than that in group A,and D2B time in group C was shorter than that in group B,the differences were statistically significant(P<0.05).There was no significant difference in S2B time among the three groups(P>0.05).Group C and B had shorter hospitalization time and less hospitalization cost than group A,the differences were statistically significant(P<0.05).There was no significant difference in the length and cost of hospitalization between group C and group B(P>0.05).There was no significant difference in the incidence and mortality of nosocomial heart failure among the three groups(P>0.05).Conclusion The establishment of chest pain center can significantly shorten D2B of STEMI patients and reduce hospitalization costs,which is worthy of promotion.