摘要
目的 探讨二级胸痛中心管理模式在救治急性ST抬高型心肌梗死的临床应用价值。方法 回顾性分析我院从2007年1月-2009年12月急诊收治的60例急性ST抬高型心肌梗死患者的临床资料,将其与2010年1月-2013年12月急诊收治的或转院的STEMI患者58例的临床资料相比较。我院2010年开始建立二级胸痛中心管理模式,将建立前收治患者定义为对照组,建立后收治患者定义为观察组。比较两组患者死亡率、实施经皮冠状动脉介入术人数、治疗7 d后患者BNP、EF、心源性休克发生率、恶性心率失常发生率、再灌注成功率及入门-球囊时间等指标。结果 观察组死亡率、心源性休克发生率、恶性心率失常发生率显著低于对照组,实施PCI术患者占比及再灌注成功率高于对照组,差异有统计学意义（P〈0.05）。观察组患者治疗7 d后BNP及EF指标显著优于对照组,观察组入门-球囊时间短于对照组,差异有统计学意义（P〈0.05）。结论 临床使用二级胸痛中心管理模式对抢救STEMI患者效果显著,有效缩短STEMI再灌注治疗时间、降低患者死亡率、改善患者预后,值得在本地区及经济欠发达地区或边远地区推广应用。
Objective To explore the clinical application value of central management mode in second-level chest pain on rescuing patients with ST-segment elevation myocardial infarction （STEMI）. Methods From January 2007 to De- cember 2009,clinical data＂ from 60 patients with STEMI for emergency admitted into our hospital were retrospectively analyzed.The clinical data from another group of 58 patients with STEMI who were admitted into our hospital for emer- gency or transferred into our hospital ranging from January 2010 to December 2013 were selected as control.The central management mode in second-level chest pain was established in our hospital in 2010.Patients admitted into the hospi- tal before establishment were classified into control group,and after establishment,these participants were categorized into observation group.The indexes of mortality rate,number of patients by percutaneous coronary intervention （PCI）, content of brain natriuretic peptide （BNP） 7 days after therapy,ejection fraction （EF）,incidence of cardiogenic shock,in- cidence of malignant abnormalities of heart rate,reperfusion success rate,and time of door-to-balloon were compared. Results The mortality,incidence of cardiogenie shock,and incidence of malignant abnormalities of heart rate in the ob- servation group were all greatly lower than those of control group.The proportion of implementing PCI and reperfusion success rate in the observation group were higher than those of control group with statistical differences （P〈0.05）.In the observation group,indexes of BNP 7 days after therapy and EF were superior to those of control group.The time of door- to-balloon in the observation group was shorter in comparison with that in the control group,which was displayed a sta- tistical difference （P〈0.05）. Conclusion Clinical application of central management mode in second-level chest pain can obtain a remarkable effect on rescuing STEMI patients,effectively shorten therapeutic time of reperfusion in STEMI, decrease mortality,and improve patient＇s prognosis.It is worthy of promotion in local areas, economic less-developed ar- eas or remote areas.
出处
《中国当代医药》
2016年第13期35-37,40,共4页
China Modern Medicine
基金
广东省云浮市科技计划项目(WS1406)
关键词
二级胸痛中心管理模式
急性ST抬高型心肌梗死
经皮冠状动脉介入术
进门-球囊时间
Central management mode in second-level chest pain
Acute ST elevation myocardial infarction
Percuta-neous coronary intervention
Door-balloon time
