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目的探讨微信平台在急性ST段抬高心肌梗死(STEMI)患者的转运和救治流程中的应用效果。方法建立以华中科技大学同济医学院附属同济医院胸痛中心为核心,“120”院前急救系统、急诊科以及武汉市周边区域不具备直接经皮冠状动脉介入治疗(PPCI)能力的各基层医院参与的微信群。利用微信平台对疑似STEMI患者的病史和心电图等资料进行传输共享。对比分析微信平台应用之前(2014年12月1日至2015年8月31日)和之后(2015年9月1日至2016年5月31日)两组患者首次医疗接触至球囊扩张(FMC-to-B)时间、入门至球囊扩张(D-to-B)时间、住院期间死亡率以及住院天数的差异。结果微信平台应用前行PPCI的急性STEMI患者共计91例,微信平台应用后行PPCI的患者119例。两组患者支架置入、住院期间死亡率、住院时间比较,差异均无统计学意义(均P>0.05);而微信平台应用后患者的FMC-to-B时间[(115.6±34.0)min比(197.1±45.5)min,P<0.001]和D-to-B时间[(80.4±9.3)min比(133.6±36.7)min,P=0.034]时间均较微信平台应用前患者显著减少,差异均有统计学意义。结论微信平台的应用有助于不具备PPCI能力的医院对STEMI患者进行无缝隙转诊,明显缩短了FMC-to-B和D-to-B时间,提高了救治效率。
Objective To explore the application effect of WeChat platform in the transport and treatment of acute ST-segment elevation myocardial infarction (STEMI). Methods Based on the chest pain center of Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology and the “120” prehospital emergency department, emergency department and PPCI WeChat group that the hospital participates in. The use of WeChat platform on the history of suspected STEMI patients and ECG data transmission and sharing. Prior to the WeChat application (December 1, 2014 to August 31, 2015) and after (January 1, 2015 to May 31, 2016), the first medical exposure to balloon dilation (FMC -to-B) time, time from entry to D-to-B, in-hospital mortality, and length of stay. Results A total of 91 cases of acute STEMI patients undergoing WeChat PPCI and 119 cases of PPCI underwent WeChat platform. There was no significant difference in the mortality and hospital stay between the two groups (P> 0.05), while the FMC-to-B time [(115.6 ± 34.0) min vs (197.1 ± 45.5) min, P <0.001] and D-to-B time [(80.4 ± 9.3) min vs (133.6 ± 36.7) min, P = 0.034] There is statistical significance. Conclusion The application of WeChat platform can facilitate the seamless referral of STEMI patients in hospitals without PPCI, significantly shorten the time of FMC-to-B and D-to-B and improve the treatment efficiency.