上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

胸痛中心管理模式在急性ST段抬高型心肌梗死患者救治中的作用

侯旭敏1，范小红2，张晓丽1，刘倩倩1，方唯一1   

  1. 上海交通大学附属胸科医院 1.心内科， 2.院长办公室， 上海 200030
  • 出版日期:2013-10-28 发布日期:2013-10-31
  • 通讯作者: 范小红, 电子信箱: elizabethfan@sina.com。
  • 作者简介:侯旭敏（1975—），女，副主任医师，博士；电子信箱: xmhou@medmail.com.cn。
  • 基金资助:

    上海市申康医院发展中心市级医院临床管理优化项目（SHDC2012608）

Role of chest pain center management model in treatment of acute ST-segment elevation myocardial infarction

HOU Xu-min1, FAN Xiao-hong2, ZHANG Xiao-li1, LIU Qian-qian1, FANG Wei-yi1   

  1. 1.Department of Cardiology, 2.President Office, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai 200030, China
  • Online:2013-10-28 Published:2013-10-31
  • Supported by:

    Shanghai Shenkang Hospital Development Center Project, SHDC2012608

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摘要：

目的 研究胸痛中心建设前后急性ST段抬高型心肌梗死（STEMI）患者救治的差异。方法 参照国际胸痛中心协会认证的要求，建立该院胸痛中心的管理制度和流程。对胸痛中心成立前（n=82）和成立后（n=96）两组STEMI患者的基础疾病、经皮冠状动脉介入治疗（PCI）成功率、入门-球囊扩张时间（D2B）、平均住院时间、人均住院费用及院内病死率进行比较。结果 与胸痛中心成立前比较，胸痛中心成立后患者的基础疾病构成比和PCI成功率无明显变化（P>0.05），但D2B缩短了45.8 min（40.7%），平均住院时间缩短了2.5 d（25.3%），人均住院费用减少了6 103元（13.1%），院内病死率明显降低（65.2%）（P<0.01）。结论 采用国际化胸痛中心管理模式，有效缩短了对STEMI患者的救治时间、明显降低了病死率，是控制医疗费用和提高服务质量的有效方法。

关键词: 胸痛中心, 急性心肌梗死, 管理模式

Abstract:

Objective To investigate the change of treatment of acute ST-segment elevation myocardial infarction (STEMI) after chest pain center onstruction. Methods According to the accreditation of Society of Chest Pain Center, the specific management system and flow-path were established in the hospital. The demographic data, success rates of percutaneous coronary intervention (PCI), door-to balloon time (D2B), mean length of hospital stay, average hospitalization expense per capita and in-hospital mortality were compared between patients treated before chest pain center construction (n=82) and those treated after chest pain center
construction (n=96). Results There was no significant difference in the constituent ratios of baseline diseases and success rate of PCI between patients treated before chest pain center construction and those treated after chest pain center construction (P>0.05). Compared with patients treated before chest pain center construction, those treated after chest pain center construction had shorter D2B and mean length of hospital stay by 45.8 min (40.7%) and 2.5 d (25.3%) respectively, less average hospitalization expense per capita by 6 103 yuan (13.1%) and lower in-hospital mortality by 65.2% (P<0.01). Conclusion The international management model of chest pain center effectively reduces the rescue time and decreases the mortality in patients with STEMI, which may be an effective method to control the medical expense and improve the service quality.

Key words: chest pain center, acute myocardial infarction, management model