摘要
目的急性ST段抬高型心肌梗死是临床上常见疾病,其病情发展迅速,病情凶险,在心肌梗死2h内进行诊断及治疗是关键,PDCA是通过加强对个体的关注以改进胸痛救治中心的流程,从而增加对患者的关注程度及救治效率。故胸痛中心应用PDCA改善急性ST段抬高型心肌梗死患者结局的效果。方法选取2018年1月至2019年12月于韶关市第一人民医院胸痛中心急性ST段抬高型心肌梗死(STEMI)并且接受急诊PCI治疗的患者82例,采用SPSS统计软件按照随机数字表法分为对照组及观察组,均为41例;对照组采用常规的急诊胸痛中心救治方案,观察组采用针对胸痛中心救治应用个体化持续改进措施,观察两组患者救护时间、手术情况、术后不良事件发生情况。结果观察组首份心电图完成时间、肌钙蛋白T出结果时间、建立静脉通道用时均低于对照组两组对比,差异具有统计学意义(P<0.05);观察组门球时间(D2B)、首次医疗接触-球囊扩张时间(FMB2C)、穿刺球囊时间(P2B)均短于对照组,两组对比,差异具有统计学意义(P<0.05);观察组术后不良反应发生率9.76%低于对照组31.70%,两组对比,差异具有统计学意义(P<0.05)。结论PDCA应用于胸痛中心急性ST段抬高型心肌梗死可以缩短患者诊断及救护时间,加快手术进程,减少术后不良反应的发生。
Objective Acute ST segment elevation myocardial infarction(AMI)is a common disease in the clinic,which has a rapid progression and a homicide course,and diagnosis and treatment within two hours of MI are the key points,PDCA is an urgent treatment strategy for patients by enhancing the attention of individuals to improve the process of care centers for chest pain,thereby increasing the focus on patients and the efficiency of rescue and treatment.Therefore,a chest pain center applied PDCA to improve the outcome of patients with acute ST elevation myocardial infarction.Methods A total of 82 patients who presented with acute ST segment elevation myocardial infarction(STEMI)and underwent emergency PCI in the chest pain center of our hospital from January 2018 to December 2019 were selected and divided into control and observation groups according to the random number table method using SPSS statistical software,and 41 patients were included in the control group.The control group used a routine emergency chest pain center rescue protocol,and the observation group used a targeted chest pain center rescue application.The continuous improvement measures were individualized to observe the rescue time,the operation situation,and the occurrence of postoperative adverse events in the two groups.Results Time to completion of first ECG,time to results of troponin T withdrawal,and time to establishment of venous access were lower in the observation group than in the control group(P<0.05),and the door to balloon time(D2B),time to first medical contact balloon dilatation(FMB2C),and time to puncture balloon(P2B)were shorter in the observation group than in the control group significance(P<0.05);the incidence of postoperative adverse effects in the observation group of 9.76%was lower than that in the control group of 31.70%.The difference between the two groups was statistically significant(P<0.05).Conclusion The application of PDCA to acute ST elevation myocardial infarction in a chest pain center can shorten the diagnosis and ambulance time of patients,accelerate the process of surgery,and reduce the occurrence of postoperative adverse reactions.
作者
何怡妮
曾斐
黄迎春
HE Yi-ni;ZENG Fei;HUANG Ying-chun(Emergency Department,the First People’s Hospital of Shaoguan,Shaoguan,Guangdong 512000)
出处
《智慧健康》
2021年第23期84-86,共3页
Smart Healthcare
关键词
胸痛中心
救护时间
心肌梗死
不良反应
手术情况
D2B
Chest pain center
Ambulance time
Myocardial infarction
Adverse effects
Surgical situation
D2B
