医联体单位通过胸痛单元建设对STEMI患者救治的影响

The Effect of Chest Pain Unit in the Medical Conjoined Units on the Treatment of Patients With STEMI

目的探讨医联体单位通过胸痛单元建设对急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者救治的影响。方法选取2021年1月—2022年6月实施医联体单位胸痛单元建设应用前首诊在医联体内非PCI医院由医联体内非PCI医院转诊至厦门市海沧医院胸痛中心进行直接经皮冠状动脉介入治疗(primary percutaneous coronary intervention,PPCI)救治的36例STEMI患者作为对照组,选择2022年7月—2023年6月实施医联体单位胸痛单元建设应用后首诊在医联体内非PCI医院由医联体内非PCI医院转诊至厦门市海沧医院胸痛中心进行PPCI救治的31例STEMI患者作为研究组。对两组患者出现症状到首次医疗接触时间(first medical contact,FMC)、非PCI医院停留时间(door-in and door-out,DIDO)、DIDO达标率、PPCI患者入门至导丝通过的时间(door-to-wire,D-to-W)、D-to-W达标率、再灌注、院内心血管不良事件发生率及患者满意度进行分析。结果两组患者FMC比较,差异无统计学意义(P>0.05);研究组DIDO、D-to-W、DIDO达标率及D-to-W达标率优于对照组(P<0.05);两组再灌注率及院内心血管不良事件发生率比较,差异无统计学意义(P>0.05);研究组患者总满意度高于对照组(P<0.05)。结论医联体形势下胸痛单元的建设和应用可大大缩短首次就诊在非PCI医院STEMI患者的DIDO、D-to-W,为患者的救治争取宝贵的时间,同时也显著提升患者对医疗机构的就医满意度。

Objective To explore the effect of chest pain unit in the medical conjoined units on the treatment of patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 36 patients with STEMI were selected as the control group from January 2021 to June 2022 who were referred from the non-PCI hospital to the chest pain center of Xiamen Haicang Hospital for PPCI before application of the chest pain unit in the medical conjoined units.A total of 31 patients with STEMI were selected as the study group from July 2022 to June 2023 who were referred from the non-PCI hospital to the chest pain center of Xiamen Haicang Hospital for PPCI after application of the chest pain unit in the medical conjoined units.Time from onset of symptoms to first medical contact(FMC),door-in and doorout(DIDO),DIDO compliance rate,door-to-wire(D-to-W),D-to-W compliance rate of PPCI patients,reperfusion,incidence of in-hospital cardiovascular adverse events,and patient satisfaction were analyzed.Results There was no significant difference in FMC between the two groups(P>0.05).The DIDO,D-to-W,DIDO compliance rate and D-to-W compliance rate in the study group were better than those in the control group(P<0.05).There was no significant difference in the rate of reperfusion and the incidence of cardiovascular adverse events between the two groups(P>0.05).The total satisfaction of the study group was higher than that of the control group(P<0.05).Conclusion The construction and application of chest pain unit in the situation of medical union can greatly shorten the DIDO and D-to-W of STEMI patients in non-PCI hospitals for the first time,gain valuable time for the treatment of patients,and significantly improve patients'satisfaction with medical institutions.