急性ST段抬高型心肌梗死患者进门-球囊扩张时间及其各时间点的分析

Analysis in door to balloon dilation time and its time points in patients with acute ST segment elevation myocardial infarction

  • 摘要:
      目的  分析急性ST段抬高型心肌梗死(STEMI)患者急诊经皮冠状动脉介入术(PCI)进门-球囊扩张时间(DTB)及其各时间点的特征。
      方法  收集2018年1月—2020年12月行急诊PCI的180例STEMI患者的DTB及其各时间点(急诊停留时间、转运时间和介入时间)数据。将患者依据不同标准分为DTB达标组和DTB非达标组,工作时间组和非工作时间组,自费组和非自费组,2018年组和2020年组。比较各组的相关指标。
      结果  180例STEMI患者平均DTB为(115.0±51.9)min;急诊停留时间为(71.4±50.3)min,其中进门至呼叫心内科时间为(10.9±6.1)min,呼叫心内科至签署知情同意书时间为(31.4±30.4)min,签署知情同意后至离开急诊室时间为(39.5±31.6)min;转运时间为(4.4±1.3)min;介入时间为(35.2±13.1)min。DTB达标组的DTB、急诊停留时间均短于DTB未达标组,差异有统计学意义(P < 0.05)。工作时间组与非工作时间组DTB、急诊停留时间、签署同意书至离开急诊时间比较,差异均有统计学意义(P < 0.05)。自费组和非自费组DTB及各时间点情况比较,差异均无统计学意义(P>0.05)。2020年组的DTB、急诊停留时间均短于2018年组,差异有统计学意义(P < 0.05)。
      结论  获取知情同意、介入导管室准备是急诊STEMI患者DTB延长的主要因素,建立院前、院内的无缝衔接的规范流程,可有效缩短DTB。

     

    Abstract:
      Objective  To analyze the features of door to balloon (DTB) dilation time and its time points in patients with acute ST segment elevation myocardial infarction (STEMI) by emergency percutaneous coronary intervention (PCI).
      Methods  Data of DTB and its time points (emergency retention time, transit time and intervention time) in 180 STEMI patients with emergency PCI from January 2018 to December 2020 were collected. According to different standards, patients were divided into standard DTB group and non-standard DTB group, working time group and non-working time group, self-paid group and non-self-paid group, and 2018 group and 2020 group. The related indexes were compared between groups.
      Results  Average DTB of 180 STEMI patients was (115.0±51.9) min; the emergency retention time was (71.4±50.3) min, in which door to Cardiology Department response time was (10.9±6.1) min, Cardiology Department response to informed consent confirmation time was (31.4±30.4) min, and the informed consent confirmation to out of emergency room time was (39.5±31.6) min; the transit time was (4.4±1.3) min; the intervention time was (35.2±13.1) min. DTB and emergency retention time of the standard DTB group were significantly shorter than those of the non-standard DTB group (P < 0.05). There were significant differences in DTB, emergency retention time and the informed consent confirmation to out of emergency room time between the working time group and the non-working time group (P < 0.05). There were no significant differences in DTB and its time points between the self-paid group and the non-self-paid group (P>0.05). DTB and emergency retention time in the 2020 group were significantly shorter than those in the 2018 group (P < 0.05).
      Conclusion  Obtaining informed consent and interventional catheterization preparation are the main factors for DTB extension in emergency STEMI patients. Establishing a standard process of pre-hospital and in-hospital seamless connection can effectively shorten DTB.

     

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