本文關鍵詞： 經皮冠狀動脈介入治療 轉運 心肌梗死　出處：《首都醫(yī)科大學學報》2017年03期 　論文類型：期刊論文

【摘要】：目的探討基層醫(yī)院通過智能手機微信院前激活導管室對急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)病人再灌注時間的影響。方法通過智能手機微信群,潞河醫(yī)院與120急救中心及周邊20余家非急診經皮冠狀動脈介入(percutaneous coronary intervention,PCI)基層醫(yī)院建立STEMI病人區(qū)域協(xié)同救治系統(tǒng)。將2015年7月至2016年7月微信群建立后基層醫(yī)院轉診的STEMI病人分為2組:導管室組(n=48)通過微信群激活、急救服務系統(tǒng)(Emergency Medical System,EMS)120將病人直接送入導管室。對照組(n=52),通過微信群激活、EMS將病人送至急診后再送導管室。比較2組病人首次醫(yī)療接觸至器械(first medical contact-to-device,FMC2D)時間、FMC2D時間指南達標率和門器械(door to device,D2D)時間。結果 2組病人的基線臨床資料和冠狀動脈造影資料差異均無統(tǒng)計學意義(P均0.05)。與對照組相比,導管室組的FMC2D中位數時間明顯縮短(98.0 min vs 151.4 min,P0.001),FMC2D時間指南達標率明顯提高(60.4%vs 25.0%,P0.001),D2D中位數時間明顯縮短(21.7 min vs 54.0 min,P0.001)。住院期間2組各死亡2例(4.17%vs 3.85%,P0.05)。結論基層醫(yī)院通過微信激活導管室將STEMI病人直接轉運至導管室可明顯縮短FMC2D和D2D時間,提高FMC2D達標率。
[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.
【作者單位】： 首都醫(yī)科大學潞河教學醫(yī)院心內科;首都醫(yī)科大學宣武醫(yī)院心臟科;
【基金】：通州區(qū)衛(wèi)生發(fā)展科研專項(TWKY-2016-ZD-01-08)~~
【分類號】：R473.5
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本文編號：1502412