摘要
目的探讨区域协同救治体系对就诊于未具备经皮冠状动脉介入治疗(PCI)能力医院(非PCI医院)的急性ST段抬高心肌梗死(STEMI)患者早期救治时间节点的影响。方法从广州军区广州总医院胸痛中心网络数据库中调取2010年4月至2014年3月之间的数据,分析区域协同救治体系建立前后非PCI医院在STEMI患者首次医疗接触(FMC)后早期关键诊疗措施实施的时间变化。结果期间共有1024例STEMI患者直接就诊于区域协同救治网络内的非PCI医院,建立区域协同救治体系后,非PCI医院FMC至首份心电图时间从基线平均(31±12)min缩短至(9±6)min(P=0.000),10 min内完成首份心电图的患者比例达84.4%;FMC至使用负荷剂量阿司匹林的时间从平均(60±23)min缩短至(20±13)min(P=0.000);对于溶栓患者,FMC至开始溶栓时间从平均(74±28)min缩短至(31±12)min(P=0.000),其中79.0%的患者能在30 min内开始溶栓治疗;对于转运PCI患者,入门至转出时间从平均(125±59)min缩短至(63±39)min(P=0.000),但只有29.7%的患者能在30 min内转运出非PCI医院。结论区域协同救治体系大大缩短了非PCI医院对STEMI患者的早期救治时间。
Objective To investigate the impact of regional collaborative network on rescue timeline of the patients with ST elevated myocardial infarction（ STEMI） in hospitals not capable of PCI.Methods This is a rectrospective analysis from the collaborative network database of chest pain center in Guangzhou General Hospital of Guangzhou Military Command. The early rescue timelines after first medical contact（ FMC） of STEMI patients in the non-PCI hospitals were compared between before（ from April,2010 to March,2011） and after（ from April,2011 to March,2014） the establishment of the regional collaborative network. Results A total of 1024 STEMI patients were included in the study. Compared with the baselines of before the establishment of the regional collaborative network,the mean FMC to the first electrocardiogram time was significantly shorten from（ 31 ± 12） min to（ 9 ± 6） min（ P = 0. 000） and the ratio of less than 10 min was 84. 4%. The mean time of FMC to loading dose of aspirin was decreased from（ 60 ± 23） min to（ 20 ± 13） min（ P = 0. 000）. Among the patients who received thrombolytic therapy,the average FMC to needle time decreased from（ 74 ± 28） min to（ 31 ± 12） min（ P = 0. 000） and the ratio of below 30 min was 79. 0%. Among patients undergoing transfer-PCI,the mean door-in-and-door-out time was remarkably shortened from（ 125 ± 59） min to（ 63 ± 39） min（ P = 0. 000）,and the ratio of below 30 min was 29. 7%. Conclusions The regional collaborative network significantly shorten the rescue timeline of STEMI patients in non-PCI capable hospitals.
出处
《中国介入心脏病学杂志》
2015年第3期125-128,共4页
Chinese Journal of Interventional Cardiology
基金
广东省科技计划重大项目(2012A080104020)
广州市重点实验室建设专项(穗科信字[2013]163-15)
广州市重大科技计划专项(2014Y2-00068)
广东省医疗物联网推广应用工程(粤经信[2014]975)
关键词
急性心肌梗死
再灌注
胸痛中心
区域协同救治体系
Acute myocardial infarction
Reperfusion
Chest pain center
Regional collaborative network
