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目的:研究胸痛患者行急诊PCI通道时间点的监测及影响因素分析。方法:共纳入2016年01月至12月入我院急诊科胸痛患者符合PCI指征患者共188例,统计患者基线资料包括性别、年龄、ACS类型、体质量指数(BMI)、合并基础疾病,临床资料包括就诊时间、发病时间、心电图时间、肌钙蛋白抽血和报告时间、通知心内科住院总时间、双联抗血小板药物时间、开始谈话时间、签署知情同意书时间、通知导管团队和到位时间、通知转运和到达导管室时间、鞘管置入时间、球囊扩张或抽吸时间,分析D-to-B平均时间和合格率,采用多因素Lo-gistic回归模型分析D-to-B延误的影响因素。结果:所有患者D-to-B平均时间(55.6±16.8)min,合格率41.48%(78/188),合格组与不合格组患者的基线资料比较无差异(P>0.05)。两组就诊时间、发病时间、心电图时间、肌钙蛋白抽血和报告时间比较无差异(P>0.05),但合格组其他时间较不合格组均显著缩短(P<0.05)。Logistic回归分析得出:通知心内科住院总时间、通知导管团队和到位时间、通知转运和到达导管室时间是影响D-to-B的独立危险因素(P<0.05)。结论:监测胸痛患者行急诊PCI通道的时间点对缩短D-to-B时间有较好应用价值。
Objective: To study the monitoring and influencing factors of the time of emergency PCI in chest pain patients. METHODS: A total of 188 patients with chest pain who were admitted to our emergency department between January 2016 and December 2016 were enrolled in this study. Baseline data included sex, age, type of ACS, body mass index (BMI), underlying diseases, Clinical data including visit time, onset time, electrocardiogram time, blood drawing and reporting time of troponin, total time of cardiology hospitalization, dual antiplatelet drug time, start talking time, time of signed informed consent, notification of catheterization team and placement D-to-B was analyzed by multi-factor Lo-gistic regression model, and the time of delivery, catheterization time, sheath insertion time, balloon dilation and aspiration time were analyzed. Factors affecting the delay. Results: The average D-to-B time was 55.6 ± 16.8 min in all patients, with a pass rate of 41.48% (78/188). There was no significant difference in baseline data between eligible and unqualified patients (P> 0.05). There was no difference in the time of treatment, onset time, electrocardiogram time, blood flow of troponin and reporting time between the two groups (P> 0.05). However, the other groups in the qualified group were significantly shorter than those in the unqualified group (P <0.05). Logistic regression analysis showed that the total time of inpatient hospitalization, the catheterization team and the time in place were noticed, and the timing of delivery and arrival in the catheterization room were independent risk factors for D-to-B (P <0.05). Conclusion: It is of great value to shorten the D-to-B time in monitoring the time of emergency PCI in chest pain patients.