论文部分内容阅读
目的:分析中国胸痛中心联盟认证对提高急性ST段抬高型心肌梗死救治速度的影响。方法:回顾分析我院胸痛中心在认证前后患者的救治数据(2015年1月1日至12月31日间患者纳入认证前组,2016年1月1日至8月31日间患者纳入认证后组),对比分析患者基线情况、绕行急诊科和心内科监护室而直接进导管室做手术的比率、进医院大门至球囊扩张时间(门-球时间)、门-球时间达标率、动脉穿刺到球囊扩张时间、住院天数和住院费用、死亡率等。结果:与认证前相比,绕行急诊科和心内科监护室而直接进导管室做手术比率由33.9%提高至61.05%;门-球时间由(105.75±72.02)min下降至(73.25±54.14)min;门球时间达标率从49.11%上升至73.16%;动脉穿刺到球囊扩张时间由(29.43±14.45)min下降至(22.85±11.28)min;住院天数由(9.35±6.95)d下降至(7.89±4.74)d;住院费用由(5.74±2.92)万元下降至(4.62±1.55)万元,均有统计学意义(P<0.05),但死亡率无统计学差异。结论:胸痛中心认证显著提高急性ST段抬高型心肌梗死救治速度,让患者能获得更好的治疗。
OBJECTIVE: To analyze the impact of China Chest pain Center Union certification on the treatment of acute ST-segment elevation myocardial infarction. Methods: A retrospective analysis of our hospital chest pain center before and after the certification of patients with treatment data (January 1, 2015 to December 31, patients into the pre-certification group, 2016 January 1 to August 31 after the patients into the certification Group), comparative analysis of patients with baseline conditions, bypass emergency department and cardiology department and direct access to the catheterization room operation rate, into the hospital gate to balloon expansion time (door-ball time), goal-ball time rate, Arterial puncture to balloon dilation time, hospitalization days and hospitalization costs, mortality and so on. Results: Compared with those before certification, the rate of bypassing the emergency department and cardiology department directly into the catheterization room increased from 33.9% to 61.05%, and the mean time to door-to-ball time decreased from (105.75 ± 72.02) min to (73.25 ± 54.14) ) min; the compliance rate of the goal time increased from 49.11% to 73.16%; the time from arterial puncture to balloon inflation decreased from (29.43 ± 14.45) min to (22.85 ± 11.28) min; the hospital stay decreased from (9.35 ± 6.95) days to (7.89 ± 4.74) d respectively. The cost of hospitalization decreased from (5.74 ± 2.92) million to (4.62 ± 1.55) million, both of which were statistically significant (P <0.05). However, there was no significant difference in mortality. CONCLUSIONS: The chest pain center certification significantly increases the rescue rate of acute ST-elevation MI and allows patients to obtain better treatment.