基于急救效率和安全性指标的绿色通道管理模式在心脏骤停患者中的应用效果

Application effect of green channel management mode based on first-aid efficiency and safety indexes in patients with cardiac arrest

目的:探究基于急救效率和安全性指标的绿色通道管理模式对心脏骤停患者的临床应用效果。方法:回顾性分析2021年1月-2022年12月期间本院接诊的120例心脏骤停患者的急诊数据,2021年1月-12月实施传统急救管理患者纳入传统组,2022年1月-12月实施绿色通道管理患者纳入绿色通道组,两组均为60例。对比两组救治成功率、急诊效率、不良事件;所有患者出院后均进行6个月随访,对比两组主要不良心血管事件(MACE)发生率。结果:与对照组比较,绿色通道组急救成功率显著升高(75.00%比91.67%)(χ^(2)=6.000,P=0.014);绿色通道组的转运时间[(9.06±0.59)min比(5.38±0.43)min]、辅助检查时间[(34.03±1.10)h比(23.55±0.87)h]、急诊室滞留时间[(3.78±0.15)h比(1.67±0.09)h]和手术时间[(10.19±0.70)h比(7.71±0.29)h]显著更短(P均=0.001),不良事件发生率(20.00%比3.64%)和随访6个月期间MACE发生率(17.78%比3.64%)显著更低(P均<0.05)。结论:心脏骤停患者应用绿色通道服务流程干预可显著提高救治成功率和急诊效率,该方案能显著降低不良事件和预后主要不良心血管事件的发生率,值得推广应用。

Objective:To explore clinical application effect of green channel management mode based on first-aid efficiency and safety indicators on patients with cardiac arrest.Methods:Emergency data of 120 patients with cardiac arrest treated in our hospital from Jan 2021 to Dec 2022 were retrospectively analyzed.Patients undergoing traditional first-aid management from Jan to Dec 2021 were enrolled in traditional group,and those underwent green channel management from Jan to Dec 2022 were included in green channel group,with 60 cases in each group.Secure success rate,emergency efficiency and incidence of adverse events were compared between two groups.All patients were followed up for six months after discharge,and incidence rate of major adverse cardiovascular events(MACE)was compared between two groups.Results:Compared with the control group,there was significant rise in success rate of first-aid(75.00%vs.91.67%),χ^(2)=6.000,P=0.014;and significant reductions in transport time[(9.06±0.59)min vs.(5.38±0.43)min],auxiliary examination time[(34.03±1.10)h vs.(23.55±0.87)h],emergency room retention time[(3.78±0.15)h vs.(1.67±0.09)h]and operation time[(10.19±0.70)h vs.(7.71±0.29)h]in the green channel group(P=0.001 all).Compared with control group,there were significant reductions in incidence rates of adverse events(20.00%vs.3.64%)and MACE during the 6-month follow-up(17.78%vs.3.64%)in green channel group(P<0.05 both).Conclusion:Green channel service process intervention can significantly improve secure success rate and emergency efficiency,reduce incidence rates of adverse events and prognosis major adverse cardiovascular events in patients with cardiac arrest,which is worthy of promotion and application.