本文選題：急診　切入點：胸痛　出處：《上海交通大學》2014年碩士論文

【摘要】：目的：通過對上海急診胸痛患者血清心肌損傷標記物周轉(zhuǎn)時間（TAT）值的調(diào)查，分析如何提高急診患者的臨床救治效率，緩解急診過度擁擠現(xiàn)象。 方法：本研究為隨機、多中心、前瞻性研究，共納入上海市17所二級和三級醫(yī)院，研究對象為這些醫(yī)院急診部的急性胸痛患者，記錄以上患者的血清心肌損傷標記物TAT值，并對這些數(shù)據(jù)進行統(tǒng)計和分析。 結(jié)果：10所二級醫(yī)院和7所三級醫(yī)院的急診科，共有911例急性胸痛患者參與本次研究。肌鈣蛋白T（c-TNT）TAT值在二級醫(yī)院中位數(shù)是61分鐘（46-76分鐘），短于三級醫(yī)院的64分鐘（46-84分鐘）（p0.05）。肌鈣蛋白T（c-TNT）TAT值在中心實驗室中位數(shù)是60分鐘（42-83分鐘），，短于急診實驗室的65分鐘（53-85分鐘）（p0.05）。同時，在三級醫(yī)院就診的患者中61%（306）診斷為急性心肌梗死、28%（41）診斷為心功能不全，而在二級醫(yī)院分別為46%（187）和41%（58）。床旁快速檢驗（POCT）檢測肌鈣蛋白T（c-TNT）TAT值中位數(shù)是47分鐘（39-55.5分鐘）。 結(jié)論：本次研究發(fā)現(xiàn)二級醫(yī)院的血清心肌損傷標記物TAT值與三級醫(yī)院相似甚至更短，由此可鼓勵患者就近診治，緩解三級醫(yī)院過度擁擠現(xiàn)象。無論醫(yī)院級別，急診實驗室效率低于中心實驗室，必須提高急診實驗室效率。急診科可通過引進POCT降低TAT值，提高臨床救治效率。
[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.
【學位授予單位】：上海交通大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R459.7

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相關(guān)期刊論文 前1條

1 李棟,李艷,余紅,李從榮;現(xiàn)代醫(yī)院檢驗科“速度管理”的必要性[J];中華檢驗醫(yī)學雜志;2004年06期

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