摘要
目的探讨建立标准化胸痛中心对缩短急诊胸痛患者关键诊疗时间节点(包括就诊等待时间、检查获取时间及总体急诊停留时间)的实际效果。方法采用前后对照研究设计,纳入我院2018年1月—2024年12月(胸痛中心建立前后)收治的急诊胸痛患者共105例。其中,胸痛中心建立前组45例,建立后组60例。比较两组患者在肌钙蛋白获得时间(从抽血到获得结果的时间)、首份心电图获得时间(首次医疗接触至首份心电图时间)、急诊停留总时间以及接受直接经皮冠状动脉介入治疗(PCI)的ST段抬高型心肌梗死(STEMI)患者的入门-球囊扩张(D2B)时间和D2B时间达标率(≤90 min)等指标。结果胸痛中心建立后,建立后组肌钙蛋白获得时间、首份心电图获得时间及急诊停留总时间均较建立前组显著缩短(均P<0.05)。在STEMI行PCI患者亚组中,建立后组的D2B时间较建立前组显著缩短(P<0.001)。同时,建立后组的D2B达标率(85.19%)显著高于建立前组(9.09%)(P<0.001)。结论建立并运行标准化胸痛中心能显著优化急诊胸痛患者的诊疗流程,可有效缩短包括关键检查等待时间在内的多个时间,极大地提升需行急诊PCI的STEMI患者的救治效率,为改善患者预后奠定重要基础。
Objective To evaluate the role of a standardized chest pain center in reducing key time metrics in the emergency management of chest pain patients,including door-to-consultation time,test acquisition time,and total emergency department(ED)length of stay.Methods A pre-post comparative study was conducted involving 105 emergency chest pain patients admitted between January 2018 and December 2024(before and after chest pain center establishment).The pre-implementation group comprised of 45 patients,and the post-implementation group 60 patients.Key time metrics were compared between the two groups in terms of time to troponin result(from blood draw to result availability),time to first ECG(from first medical contact to ECG acquisition),total ED length of stay,and among ST-segment elevation myocardial infarction(STEMI)patients undergoing primary percutaneous coronary intervention(PCI),door-to-balloon(D2B)time and the rate of D2B time compliance(≤90 minutes).Results After the chest pain center establishment,the post-implementation group showed significantly shorter times to troponin result,first ECG acquisition,and total ED stay(all P<0.05).In the STEMI PCI subgroup,D2B time was significantly shorter in the post-implementation group(P<0.001).Moreover,the D2B compliance rate was significantly higher in the post-implementation group(85.19%)compared to the pre-implementation group(9.09%)(P<0.001).Conclusion The establishment and operation of a standardized chest pain center significantly optimizes the emergency care process for chest pain patients,effectively shortens multiple critical time intervals,and markedly improves treatment efficiency for STEMI patients requiring emergency PCI,thereby laying an important foundation for enhanced patient outcomes.
作者
李松兴
郑勇
李清香
LI Songxing;ZHENG Yong;LI Qingxiang(Qingyuan Qingxin People’s Hospital,Qingyuan,511800)
出处
《现代医院》
2025年第11期1714-1717,共4页
Modern Hospitals
