[1]王 军,陈 浩,刘晶晶,等.胸痛中心成立对急诊PCI治疗STEMI患者D2B时间的影响[J].医学信息,2020,33(10):104-107.[doi:10.3969/j.issn.1006-1959.2020.10.027]
　WANG Jun,CHEN Hao,LIU Jing-jing,et al.Effect of the Establishment of Chest Pain Center on D2B Time of Emergency PCI for STEMI Patients[J].Medical Information,2020,33(10):104-107.[doi:10.3969/j.issn.1006-1959.2020.10.027]
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胸痛中心成立对急诊PCI治疗STEMI患者D2B时间的影响()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年10期
页码:
104-107
栏目:
临床研究
出版日期:
2020-05-15

文章信息/Info

Title:
Effect of the Establishment of Chest Pain Center on D2B Time of Emergency PCI for STEMI Patients
文章编号:
1006-1959（2020）10-0104-04
作者:
王 军; 陈 浩; 刘晶晶; 等
（北京市门头沟区医院心血管内科，北京 102300）
Author(s):
WANG Jun; CHEN Hao; LIU Jing-jing; et al
(Department of Cardiology,Beijing Mentougou District Hospital,Beijing 102300,China)
关键词:
胸痛中心; 入院至球囊扩张; 经皮冠状动脉介入
Keywords:
Chest pain center; Admission to balloon dilatation; Percutaneous coronary intervention
分类号:
R541.4
DOI:
10.3969/j.issn.1006-1959.2020.10.027
文献标志码:
A
摘要:
目的 探讨胸痛中心对急诊经皮冠状动脉介入（PCI）治疗急性ST段抬高型心肌梗死（STEMI）患者入院至球囊扩张（D2B）时间的影响。方法 选取2018年1月1日~11月31日未成立胸痛中心行急诊PCI治疗的STEMI患者52例设为对照组，另外选取2018年12月1日~2019年11月31日胸痛中心成立之后行急诊PCI治疗的STEMI患者56例设为观察组。对照组给予常规流程，观察组给予胸痛中心急诊流程，比较两组发病时间、非正常工作时间发病占比、D2B各主要时间节点，并分析D2B≥90 min的影响因素。结果 两组发病时间、非正常工作时间发病占比比较，差异无统计学意义（P＞0.05）。观察组首份心电图时间、D2B时间、导管室启动至导管室激活时间、STEMI确诊至服用双联抗血小板时间均短于对照组，差异有统计学意义（P＜0.05）；两组进门至心内科医师首诊时间、心内科医师首诊至导管室启动时间、导管室激活至到达导管室时间、入导管室至球囊时间、知情同意时间、确诊至启动导管室时间比较，差异均无统计学意义（P＞0.05）。单因素分析显示，非正常工作时间、首份心电图时间、导管室启动至导管室激活时间、心内科医师首诊至导管室启动时间、导管室激活至患者到达导管室时间和STEMI确诊至服用双联抗血小板时间与D2B≥90 min相关（P＜0.05）；多因素分析显示，导管室启动至导管室激活时间、心内科医师首诊至导管室启动时间和导管室激活至患者到达导管室时间是D2B≥90 min的影响因素。结论 胸痛中心成立有助于STEMI患者进行急诊PCI治疗，缩短D2B时间，而影响我院胸痛中心D2B超时的主要因素有导管室启动至导管室激活时间、心内科医师首诊至启动导管室时间和导管室激活至患者到达导管室时间，应针对D2B影响因素进行持续改进。
Abstract:
Objective To investigate the effect of chest pain center on the time from admission to balloon dilatation (D2B) in patients with acute ST-segment elevation myocardial infarction (STEMI) treated by emergency percutaneous coronary intervention (PCI).Methods 52 patients with STEMI who did not establish a chest pain center for emergency PCI treatment from January 1st to November 31st, 2018 were selected as the control group, and also selected from December 1st 2018 to November 31st, 2019 after the establishment 56 cases of STEMI patients treated with emergency PCI were set as observation group. The control group was given a routine procedure, and the observation group was given a chest pain center emergency procedure, comparing the incidence time of the two groups, the incidence of abnormal working hours, the main time nodes of D2B, and analyzing the influencing factors of D2B ≥90 min.Results There was no statistically significant difference between the two groups in the time of onset and the percentage of abnormal working hours (P>0.05).The observation group’s first ECG time, D2B time, the time from the start of the catheter room to the activation of the catheter room, the time from STEMI diagnosis to taking dual antiplatelet were shorter than the control group, the difference was statistically significant (P<0.05);comparison of the time from the door to the cardiologist’s first consultation, the cardiologist’s first diagnosis to the catheterization room start time, the catheterization room activation to the catheterization room time, the catheterization room to the balloon time, the informed consent time, and the diagnosis to start the catheterization room comparison,the difference was not statistically significant (P>0.05). Single factor analysis showed that abnormal working hours, first ECG time, catheter room start to catheter room activation time, cardiologist first consultation to catheter room start time, catheter room activation to patient arrival catheter room time and STEMI diagnosis to take double anti-platelet time was related to D2B≥90 min (P<0.05); multivariate analysis showed that the time from the start of the catheter room to the activation of the catheter room, the time from the first visit of the cardiologist to the start of the catheter room and the time from the activation of the catheter room to the time the patient arrived is the influencing factor of D2B≥90 min.Conclusion The establishment of the chest pain center will help STEMI patients to undergo emergency PCI treatment and shorten the D2B time. The main factors that affect the D2B timeout of our chest pain center are the time from the start of the catheter room to the activation of the catheter room, the time from the first visit of the cardiologist to the start of the catheter room and the catheter From the time the room is activated until the patient arrives at the catheter room, continuous improvement should be made in response to the D2B influencing factors.

参考文献/References:

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更新日期/Last Update: 2020-05-15