胸痛中心模式对急性ST段抬高型心梗患者急救质量和预后的影响

Effect of Chest Pain Center Mode on Emergency Treatment Quality and Prognosis in Patients with Acute ST-segment Elevation Myocardial Infarction

目的:分析胸痛中心模式对急性ST段抬高型心梗(STEMI)患者急救质量和预后的影响。方法:回顾性分析2019年1月—2021年12月靖江市人民医院急诊科接诊的146例STEMI患者的资料,按照接诊模型的不同分为观察组(n=78)和对照组(n=68),对照组为常规接诊模式接诊,观察组为胸痛中心模式接诊。观察两组发病-首次医疗接触(S2FMC)时间、急诊停留时间、首份心电图时间、心肌损伤标志物时间、经皮冠状动脉介入治疗(PCI)时间、院内心衰率和死亡率。随访3个月,观察两组预后情况,包括再住院率和不良事件发生率。结果:观察组S2FMC时间、急诊停留时间、首份心电图时间、心肌损伤标志物时间和PCI时间均短于对照组,差异有统计学意义(P<0.05)。观察组院内心衰率低于对照组,差异有统计学意义(P<0.05);两组院内死亡率比较,差异无统计学意义(P>0.05)。观察组3个月内再住院率和不良事件总发生率低于对照组,差异有统计学意义(P<0.05);两组再发心肌梗死率、心衰发生率和心源性死亡发生率等单项不良事件发生率比较,差异无统计学意义(P>0.05)。结论:胸痛中心模式可以缩短STEMI患者的救治时间,提高救治效率,改善短期预后。

Objective:To analyze the effect of chest pain center mode on emergency treatment quality and prognosis in patients with acute ST-segment elevation myocardial infarction(STEMI).Method:A retrospective analysis was conducted on 146 STEMI patients admitted to the Emergency Department of Jingjiang People's Hospital from January 2019 to December 2021.They were divided into observation group(n=78)and control group(n=68)based on different admission models.The control group was treated with routine admission mode,while the observation group was treated with chest pain center mode.Observed the onset time of first medical contact(S2FMC),emergency stay time,first electrocardiogram time,myocardial injury marker time,percutaneous coronary intervention(PCI)time,hospital heart failure rate,and mortality rate in both groups.Follow up for 3 months to observed the prognosis of both groups,including readmission rate and incidence of adverse events.Result:The S2FMC time,emergency stay time,first electrocardiogram time,myocardial injury marker time,and PCI time of the observation group were all shorter than those of the control group,the differences were statistically significant(P<0.05).The hospital heart failure rate in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in hospital mortality rate between the two groups(P>0.05).The readmission rate and total incidence of adverse events within 3 months in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).There were no statistically significant differences in the incidence of single adverse events such as recurrent myocardial infarction,heart failure,and cardiac death between the two groups(P>0.05).Conclusion:The chest pain center mode can shorten the treatment time of STEMI patients,improve treatment efficiency,and improve short-term prognosis.