胸痛中心建设对急性ST段抬高心肌梗死救治效果的影响

    Effect of chest pain center construction on treatment of acute ST-segment elevation myocardial infarction

    • 摘要:
      目的探讨胸痛中心的建设与常规诊疗流程对急性ST段抬高型心肌梗死(STEMI)行急诊经皮冠状动脉介入治疗救治效果的影响。
      方法选择胸痛中心建设前后的STEMI病人分别作为对照组(n=50)与观察组(n=56),比较2组病人的救治时间、住院期间心衰发生率与死亡率及术后3个月左心室内径、左心室射血分数、肌酐水平、再入院率情况。
      结果观察组首次医疗接触-球囊扩张(FMC-to-B)时间、到达医院大门-球囊扩张时间(D-to-B)、住院时间、住院期间心衰发生率与死亡率、术后出院前左心室射血分数均低于对照组(P < 0.05~P < 0.01)。2组病人术后3个月随访,观察组左心室内径和左心室射血分数较对照组均明显改善(P < 0.01),2组肌酐水平和再入院率差异均无统计学意义(P>0.05)。
      结论胸痛中心模式可显著缩短STEMI病人FMC-to-B时间和D-to-B时间,改善病人预后。

       

      Abstract:
      ObjectiveTo investigate the effect of chest pain center construction and routine diagnosis and treatment procedure on the efficacy of emergency percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction(STEMI).
      MethodsPatients with STEMI before and after the chest pain center construction were selected as control group(n=50) and observation group(n=56).The treatment time, incidence of heart failure and mortality during hospitalization, and left ventricular diameter, left ventricular ejection fraction, creatinine level and readmission rate three months after surgery were compared between the two groups.
      ResultsThe first medical contact-to-balloon(FMC-to-B) time, door-to-balloon(D-to-B) time, hospitalization time, incidence of heart failure and mortality during hospitalization, and left ventricular ejection fraction before discharge in observation group were lower than those in control group(P < 0.05 to P < 0.01).After three months of follow-up, the left ventricular diameter and left ventricular ejection fraction in observation group were significantly improved compared with those in control group(P < 0.01), but there was no significant difference in creatinine level and readmission rate between the two groups(P>0.05).
      ConclusionsChest pain center mode can significantly shorten the FMC-to-B time and D-to-B time in STEMI patients, and improve the prognosis of patients.

       

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