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个体化持续改进对胸痛中心救治急性心肌梗死患者效率的影响

Effect of individualized continuous improvement on the treating efficiency of patients with acute myocardial infarction in chest pain center

  • 摘要: 目的:分析个体化持续改进对于提高胸痛中心急性心肌梗死患者救治效率的影响。方法:分别提取2017和2019年1月至4月某院胸痛中心收治的125例急性ST段抬高型心肌梗死患者的救治数据,其中2017年1至4月(改进前)73例,2019年(1至4月)改进后52例。对比分析在两时间段诊治患者的总缺血时间、门-球时间、首次医疗接触-球囊扩张时间、住院时间、住院费用等。结果:改进后,门-球时间由(85.37±15.34)min降至(72.66±19.98)min(P<0.01);穿刺-球囊扩张时间由(24.31±8.61)min降至(16.68±8.36)min(P<0.01);首次医疗接触-球囊时间由(102.88±41.23)min降至(93.64±39.41)min(P=0.038);住院时间由(10.06±3.20)d降至(8.87±2.50)d(P=0.024);首次医疗接触-球囊扩张时间达标率由67.31%(35/52)上升为78.08%(57/73,P=0.028);改进后患者预后不良比例由27.40%(20/73)降至11.54%(6/52,P=0.043)。结论:个体化持续改进可以显著提高急性ST段抬高型心肌梗死的救治效率。

     

    Abstract: Objective:To analyze the effect of individual continuous improvement on the efficiency of patients with acute myocardial infarction in chest pain center. Methods:The patients with acute ST-segment elevation myocardial infarction treated in a chest pain center from January to April in 2017 and 2019 were included. There were 73 cases from January to April in 2017 (before improvement) and 52 cases from January to April in 2019 (after improvement). The total ischemia time, door to balloon time, first medical contact-balloon dilation time, hospital stay, and hospitalization expenses were compared and analyzed before and after the improvement. Results:After individualized continuous improvement, the door to balloon time decreased from (85.37±15.34) min to (72.66±19.98) min (P<0.01), puncture to balloon time decreased from (24.31±8.61) min to (16.68±8.36) min (P<0.01), first medical contact-balloon time decreased from (102.88±41.23) min to (93.64±39.41) min (P=0.038), hospital stay decreased from (10.06±3.20) d to (8.87±2.50) d (P=0.024), first medical contact-balloon time compliance rate increased from 67.31% (35/52) to 78.08% (57/73, P=0.028), the proportion of poor prognosis was significantly reduced from 27.40% (20/73) to 11.54% (6/52, P=0.043). Conclusions:Individualized continuous improvement can improve the treatment efficiency of acute ST-segment elevation myocardial infarction obviously.

     

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