基层医院通过微信院前激活导管室对急性ST段抬高型心肌梗死病人再灌注时间的影响

发布时间：2018-02-11 06:30

  本文关键词： 经皮冠状动脉介入治疗 转运 心肌梗死　出处：《首都医科大学学报》2017年03期 　论文类型：期刊论文

【摘要】：目的探讨基层医院通过智能手机微信院前激活导管室对急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)病人再灌注时间的影响。方法通过智能手机微信群,潞河医院与120急救中心及周边20余家非急诊经皮冠状动脉介入(percutaneous coronary intervention,PCI)基层医院建立STEMI病人区域协同救治系统。将2015年7月至2016年7月微信群建立后基层医院转诊的STEMI病人分为2组:导管室组(n=48)通过微信群激活、急救服务系统(Emergency Medical System,EMS)120将病人直接送入导管室。对照组(n=52),通过微信群激活、EMS将病人送至急诊后再送导管室。比较2组病人首次医疗接触至器械(first medical contact-to-device,FMC2D)时间、FMC2D时间指南达标率和门器械(door to device,D2D)时间。结果 2组病人的基线临床资料和冠状动脉造影资料差异均无统计学意义(P均0.05)。与对照组相比,导管室组的FMC2D中位数时间明显缩短(98.0 min vs 151.4 min,P0.001),FMC2D时间指南达标率明显提高(60.4%vs 25.0%,P0.001),D2D中位数时间明显缩短(21.7 min vs 54.0 min,P0.001)。住院期间2组各死亡2例(4.17%vs 3.85%,P0.05)。结论基层医院通过微信激活导管室将STEMI病人直接转运至导管室可明显缩短FMC2D和D2D时间,提高FMC2D达标率。
[Abstract]:Objective to investigate the effect of activated catheter room in primary hospital on reperfusion time of patients with acute ST-segment elevation myocardial infraction in acute ST-segment myocardial infarction (ST-segment). Luhe Hospital established a regional cooperative treatment system for STEMI patients with 120 emergency centers and more than 20 non-emergency percutaneous coronary intervention (coronary interventionn PCI) primary hospitals. After the establishment of WeChin Group from July 2015 to July 2016, the primary hospitals were referred to each other. Patients with STEMI were divided into two groups: Catheter group (n = 48) was activated by WeChat group. The emergency Medical system EMS2D sent the patient directly to the catheter room. In the control group, the patient was sent to the emergency room after the emergency by activating the Medical. The time of first medical contact to the first medical contact-to-devicee FMC2D was compared between the two groups. Results there was no significant difference in baseline clinical data and coronary angiography data between the two groups (P < 0.05). The median time of FMC2D in the catheterization group was significantly shortened by 98.0 min vs 151.4 min vs 151.4 min / P 0.001min respectively. The median time of FMC2D was significantly increased by 60.4 vs 25.0% P0.001 / D2D. The median time of FMC2D was significantly shortened by 21.7 min vs 54.0 min / P0.001.The two patients died in each of the two groups during hospitalization (4.17 vs 3.85) P0.050.Conclusion it is possible for primary hospitals to adopt WeChat. Activating the catheter chamber to transport STEMI patients directly to the catheter chamber could significantly shorten the time of FMC2D and D2D. Improve the FMC2D compliance rate.
【作者单位】： 首都医科大学潞河教学医院心内科;首都医科大学宣武医院心脏科;
【基金】：通州区卫生发展科研专项(TWKY-2016-ZD-01-08)~~
【分类号】：R473.5
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