上海急诊胸痛患者TAT值的现状调查与分析
发布时间:2018-04-01 11:38
本文选题:急诊 切入点:胸痛 出处:《上海交通大学》2014年硕士论文
【摘要】:目的:通过对上海急诊胸痛患者血清心肌损伤标记物周转时间(TAT)值的调查,分析如何提高急诊患者的临床救治效率,缓解急诊过度拥挤现象。 方法:本研究为随机、多中心、前瞻性研究,共纳入上海市17所二级和三级医院,研究对象为这些医院急诊部的急性胸痛患者,记录以上患者的血清心肌损伤标记物TAT值,并对这些数据进行统计和分析。 结果:10所二级医院和7所三级医院的急诊科,共有911例急性胸痛患者参与本次研究。肌钙蛋白T(c-TNT)TAT值在二级医院中位数是61分钟(46-76分钟),短于三级医院的64分钟(46-84分钟)(p0.05)。肌钙蛋白T(c-TNT)TAT值在中心实验室中位数是60分钟(42-83分钟),,短于急诊实验室的65分钟(53-85分钟)(p0.05)。同时,在三级医院就诊的患者中61%(306)诊断为急性心肌梗死、28%(41)诊断为心功能不全,而在二级医院分别为46%(187)和41%(58)。床旁快速检验(POCT)检测肌钙蛋白T(c-TNT)TAT值中位数是47分钟(39-55.5分钟)。 结论:本次研究发现二级医院的血清心肌损伤标记物TAT值与三级医院相似甚至更短,由此可鼓励患者就近诊治,缓解三级医院过度拥挤现象。无论医院级别,急诊实验室效率低于中心实验室,必须提高急诊实验室效率。急诊科可通过引进POCT降低TAT值,提高临床救治效率。
[Abstract]:Objective: to investigate the serum myocardial injury marker turnover time (TATT) in emergency chest pain patients in Shanghai, and to analyze how to improve the clinical treatment efficiency and alleviate the emergency overcrowding. Methods: a randomized, multicenter, prospective study was conducted in 17 secondary and tertiary hospitals in Shanghai. The subjects were patients with acute chest pain in emergency department of these hospitals, and their serum myocardial injury markers (TAT) were recorded. And the statistics and analysis of these data. Results the emergency departments of 10 level-II hospitals and 7 level-III hospitals, A total of 911 patients with acute chest pain participated in the study. The median value of cardiac troponin T(c-TNT)TAT in the second level hospital was 61 minutes, 46-76 minutes, shorter than that in the third class hospital, 64 minutes and 46-84 minutes, respectively. The median value of cardiac troponin T(c-TNT)TAT in the central laboratory was 60. Minutes 42-83 minutes, less than 65 minutes in the emergency laboratory, 53-85 minutes. At the same time, Among the patients in the third class hospital, 61g / 306) were diagnosed as acute myocardial infarction (28mm / 41) and 46.1877) and 41g / 58.The median value of T(c-TNT)TAT for troponin was 47 minutes, 39-55.5 minutes, respectively, in the second class hospital. The median value of troponin T(c-TNT)TAT was 47-55.5 minutes in the second class hospital. The median value of troponin T(c-TNT)TAT was 47-55.5 minutes in the second class hospital. The median value of troponin T(c-TNT)TAT was 47-55.5 minutes in the second class hospital. Conclusion: in this study, we found that the TAT value of the serum myocardial injury marker in the second class hospital is similar to or even shorter than that in the third class hospital, which can encourage the patients to be treated nearby and relieve the overcrowding in the third class hospital. The efficiency of emergency laboratory is lower than that of central laboratory, so it is necessary to improve the efficiency of emergency laboratory. The emergency department can reduce the TAT value by introducing POCT and improve the efficiency of clinical treatment.
【学位授予单位】:上海交通大学
【学位级别】:硕士
【学位授予年份】:2014
【分类号】:R459.7
【参考文献】
相关期刊论文 前1条
1 李栋,李艳,余红,李从荣;现代医院检验科“速度管理”的必要性[J];中华检验医学杂志;2004年06期
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