基于多科协助的分级分区管理对急性心肌梗死的抢救效果分析

Rescue effect analysis of multi-department assisted hierarchical and regional management on acute myocardial infarction

目的:探讨基于多科协助的分级分区管理对急性心肌梗死(AMI)患者急救效率、抢救效果的影响。方法:回顾性纳入2021年1月至6月期间于核工业四一六医院急诊科接受治疗的AMI患者共55例作为常规管理组,将2022年1月至6月期间入我院急诊科接受治疗的AMI患者共67例作为分级分区管理组。比较两组急救效率相关指标、抢救时间、住院时间、抢救成功率相关指标及预后情况。结果:与常规管理组比较,分级分区管理组门球时间[(55.39±5.86)min比(31.47±5.41)min]、通道停留时间[(68.16±5.82)min比(51.17±5.06)min]、急诊室停留时间[(21.83±3.07)min比(13.04±2.75)min]、静脉通道开放时间[(5.03±1.62)min比(3.34±1.21)min]、等候时间[(91.66±5.34)min比(70.15±4.33)min]、抢救时间[(55.15±7.34)min比(25.71±5.80)min]、症状缓解时间[(66.74±9.02)h比(46.13±8.23)h]、住院时间[(7.58±2.16)d比(5.02±1.35)d]均显著缩短(P均<0.001)。分级分区管理组抢救总满意度(88.06%比70.91%)和抢救成功率(95.52%比76.36%)显著高于常规管理组,不良心血管事件总发生率(10.45%比25.45%)显著低于常规管理组(P<0.05或<0.01)。结论:基于多科协助的分级分区管理可显著提高急性心肌梗死患者急救效率和抢救效果,抢救成功率高且预后较好。

Objective:To explore the effects of hierarchical and regional management based on multi-department assistance on first-aid efficiency and rescue effect in patients with acute myocardial infarction(AMI).Methods:A total of 55 AMI patients who were treated in Emergency Department of Nuclear Industry 416 Hospital between January and June 2021 were retrospectively enrolled as routine management group,another 67 AMI patients treated in our Emergency Department between January and June 2022 were enrolled as hierarchical and regional management group.First-aid efficiency related indexes,rescue time,hospital stay,rescue success rate related indexes and prognosis were compared between two groups.Results:Compared with routine management group,there were significant reductions in door-to-balloon time[(55.39±5.86)min vs.(31.47±5.41)min],passage residence time[(68.16±5.82)min vs.(51.17±5.06)min],emergency room stay time[(21.83±3.07)min vs.(13.04±2.75)min],venous channel open time[(5.03±1.62)min vs.(3.34±1.21)min],waiting time[(91.66±5.34)min vs.(70.15±4.33)min],rescue time[(55.15±7.34)min vs.(25.71±5.80)min],symptom relieving time[(66.74±9.02)h vs.(46.13±8.23)h]and hospital stay[(7.58±2.16)d vs.(5.02±1.35)d]in hierarchical and regional management group(P<0.001 all).Total satisfaction of rescue(88.06%vs.70.91%)and rescue success rate(95.52%vs.76.36%)of hierarchical and regional management group were significantly higher than those of routine management group,and total incidence rate of adverse cardiovascular events(10.45%vs.25.45%)was significantly lower than that of routine management group(P<0.05 or<0.01).Conclusion:The hierarchical and regional management based on multi-department assistance can significantly improve first-aid efficiency and rescue effect in patients with acute myocardial infarction,the rescue success rate is high and prognosis is good.