宋毓青,王楠,王昭,徐文晶,董茜,吴其明

• 1:首都医科大学附属北京地坛医院心血管内科

摘要(Abstract)：

目的探讨胸痛中心持续改进对急性ST段抬高型心肌梗死患者诊疗效果的影响及目前存在的常见问题。方法纳入首都医科大学附属北京地坛医院2016年6月至2017年6月急诊接受经皮冠状动脉介入治疗(PCI)的ST段抬高型心肌梗死患者235例,将2016年6月至2016年12月入院患者设为前组(98例),2017年1月至2017年6月入院患者设为后组(137例)。比较两组患者总缺血时间、首次医疗接触-球囊扩张(FMC-to-B)时间、入门到球囊扩张(D-to-B)时间、院前传输心电图比例、绕行急诊比例、转出医院入门-出门时间、住院时间、住院期间心力衰竭发生率、总死亡率。结果两组患者住院时间、总死亡率比较,差异均无统计学意义(均P>0.05)。后组患者总缺血时间[247.0(170.5,395.5)min比281.5(189.3,381.8)min,P=0.493]、FMC-to-B时间[135.0(90.5,209.5)min比150.0(110.8,191.8)min,P=0.205]稍小于前组,但差异均无统计学意义。后组患者D-to-B时间[56.0(34.0,72.5)min比80.5(58.0,101.5)min,P<0.001]、住院期间心力衰竭发生率(14.6%比37.8%,P<0.001)显著低于前组,而院前传输心电图比例(65.0%比24.5%,P<0.001)、绕行急诊比例(21.9%比3.1%,P<0.001)、转出医院入门-出门时间[97.0(50.0,163.0)min比61.5(36.5,103.5)min,P=0.007]显著高于前组,差异均有统计学意义。结论胸痛中心持续改进能够缩短D-to-B时间,降低住院期间心力衰竭发生率,但胸痛中心尚未降低总缺血时间、FMC-to-B时间、总死亡率,因而减少院前延误及转诊时间是胸痛中心持续改进的主要方向。

关键词(KeyWords)： 胸痛中心;持续改进;急性ST段抬高型心肌梗死

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 宋毓青,王楠,王昭,徐文晶,董茜,吴其明

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