青浦区胸痛中心建设对急性ST段抬高型心肌梗死患者救治疗效及预后研究

Study on the impacts of the construction of Qingpu District Chest Pain Center on the emergency treatment efficacy and prognosis of acute ST segment elevation myocardial infarction patients

目的探讨青浦区胸痛中心建设对急性ST段抬高型心肌梗死(STEMI)患者救治疗效及预后的影响。方法选取自2019年9月至2023年8月青浦区胸痛中心成立前、后收治的500例STEMI患者为研究对象,根据时间先后分为A组(本院胸痛中心成立前收治)与B组(本院胸痛中心成立后收治),每组各250例。比较两组患者的首份心电图(ECG)完成时间、患者从进入医院大门至导丝通过时间(D2WT)、首次医学接触至导丝通过时间(FMC2WT)、半年内主要心血管不良事件(MACE)、1周死亡发生率及术后并发症发生率、社区医务人员认知度、治疗总费用。结果B组患者首份ECG完成时间、D2WT时间、FMC2WT时间均短于A组,其达标率均高于A组,差异均有统计学意义(P<0.05)。B组半年内MACE、术后并发症发生率均低于A组,差异均有统计学意义(P<0.05)。两组患者1周内病死率比较,差异无统计学意义(P>0.05)。B组社区医务人员认知度高于A组,治疗总费用低于A组,差异均有统计学意义(P<0.05)。结论青浦区胸痛中心建设缩短STEMI患者的急诊救治时间,减少术后并发症及病死率,改善预后,降低治疗费用,提高社区医务人员认知度,效果良好。

Objective To explore the impacts of the construction of the Qingpu District Chest Pain Center on the emergency treatment efficacy and prognosis in patients with acute ST segment elevation myocardial infarction(STEMI).Methods A total of 500 STEMI patients admitted before and after the establishment of chest pain Center in Qingpu District from September 2019 to August 2023 were selected as the study objects,and were divided into group A(admitted before the establishment of chest pain center in our hospital)and group B(admitted after the establishment of chest pain center in our hospital)according to the time,with 250 cases in each group.The completion time of the first electrocardiogram(ECG),the time from entering thedoor to wire time(D2w),the time from the first medical contact to wire passage(FMC2WT),the major cardiovascular adverse events(MACE)within six months,the incidence of death and postoperative complications within one week,the awareness of community medical staff,and the total cost of treatment were compared between the two groups.Results The first ECG completion time,D2w time and FMC2WT time in group B were shorter than those in group A,and the compliance rate was higher than that in group A,with statistical significance(P<0.05).The incidence of MACE and postoperative complications in half A year in group B was lower than that in group A,and the differences were statistically significant(P<0.05).There was no significant difference in mortality within one week between the two groups(P>0.05).The awareness of community medical staff in group B was higher than that in group A,and the total treatment cost was lower than that in group A,with statistical significance(P<0.05).Conclusion The construction of the Qingpu District Chest Pain Center has shortened the emergency treatment time for STEMI patients,has reduced postoperative complications and mortality,has improved prognosis,has reduced treatment costs,and has increased the awareness of community medical staff,with good results.