规范术前谈话对急诊PCI患者球囊时间的影响
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摘要
目的探讨总住院医师应用规范化术前谈话内容对急性ST段抬高型心肌梗死(STEMI)患者急诊经皮冠状动脉支架植入术(PCI)门-球囊扩张(DTB)时间的影响。方法本研究连续入选自2017年1月1日～2017年6月30日河北省人民医院心血管内科收治并成功行PCI的STEMI患者118例,随机分为2组,试验组62例由经过培训的总住院医师采用规范化谈话内容谈话;对照组56例由未经过培训的总住院医师应用自己的谈话方式谈话,评估规范术前谈话是否可以缩短术前谈话时间,进而缩短急诊PCI患者球囊时间。结果试验组平均获得知情同意时间为(7.10±3.43)min,优于对照组的(14.64±6.06)min,差异具有统计学意义(P<0.05)。结论总住院医师采用规范化谈话内容有助于缩短获得知情同意时间,进而缩短DTB时间。
Objective To investigate the effect of total resident prescribing on the time of emergency percutaneous coronary stenting(PCI) portalballoon dilatation(DTB) in patients with acute ST-segment elevation myocardial infarction(STEMI). Methods A total of 118 STEMI patients who underwent PCI from the Department of Cardiology, Hebei Provincial People's Hospital from January 1, 2017 to June 30, 2017 were randomly divided into the experimental group and the control group. 62 patients in the trial group were interviewed by a trained general resident using standardized conversational content; 56 patients in the control group were interviewed by untrained general residents using their own conversations to assess whether preoperative preoperative conversations could shorten preoperative conversation time, and Shorten the balloon time in emergency PCI patients.Results The average informed consent time was(7.10±3.43) min in the experimental group, which was superior to the control group(14.64±6.06) min,the difference was statistically significant(P<0.05). Conclusion The use of standardized interviews by the general resident helps to shorten the time to get informed consent and thus shorten the DTB time.
Objective To investigate the effect of total resident prescribing on the time of emergency percutaneous coronary stenting(PCI) portalballoon dilatation(DTB) in patients with acute ST-segment elevation myocardial infarction(STEMI). Methods A total of 118 STEMI patients who underwent PCI from the Department of Cardiology, Hebei Provincial People's Hospital from January 1, 2017 to June 30, 2017 were randomly divided into the experimental group and the control group. 62 patients in the trial group were interviewed by a trained general resident using standardized conversational content; 56 patients in the control group were interviewed by untrained general residents using their own conversations to assess whether preoperative preoperative conversations could shorten preoperative conversation time, and Shorten the balloon time in emergency PCI patients.Results The average informed consent time was(7.10±3.43) min in the experimental group, which was superior to the control group(14.64±6.06) min,the difference was statistically significant(P<0.05). Conclusion The use of standardized interviews by the general resident helps to shorten the time to get informed consent and thus shorten the DTB time.
引文
[1]中华医学会心血管病学分会.急性ST段抬高型心肌梗死诊断和治疗指南[J].中华心血管病杂志,2015,43(5):675-690.
[2]徐泽升,王炳勋,宋志远,等.经桡动脉应用一根指引导管完成急诊左右冠状动脉造影及介入治疗的可行性[J].中国介入心脏病学杂志,2009,17(3):171-172.
[3]Zheng W,Cheuk-Man YU,Liu J,et al.Patients with ST-segment elevation of myocardial infarction miss out on early reper-fusion:when to undergo delayed revascularization[J].Journal ofGeriatric Cardiology Jgc,2017,14(8):524-531.
[4]Yudi MB,Ramchand J,Farouque O,et al.Impact of door-to-balloon time on long-term mortality in high-and low-risk pa-tients with ST-elevation myocardial infarction[J].InternationalJournal of Cardiology,2016(224):72-78.
[5]Latt H,Aung S,Kyaw K,et al.Coronary artery ectasia presenting with acute inferior wall myocardial infarction in a youngadult[J].Journal of Community Hospital Internal Medicine Per-spectives,2017,7(4):262-264.
[6]Wang R,Mei B,Liao X,et al.Determination of risk factors affecting the in-hospital prognosis of patients with acute ST seg-ment elevation myocardial infarction after percutaneous coronaryintervention[J].Bmc Cardiovascular Disorders,2017,17(1):243.
[7]Tra J,De BC,Van d WI,et al.Multicentre analysis of current ST-elevation myocardial infarction acute care pathways[J].OpenHeart,2017,4(1):e000458.
[8]中华医学会心血管病学分会.经皮冠状动脉介入治疗指南(2009)[J].中华心血管病杂志,2009, 30(1):55-64.
[9]李钧,陈天葆.麻醉前谈话的方法和技巧[J].中国医学伦理学,2010,23(3):37-38.
[10]霍勇,陈明.急性ST段抬高心肌梗死介入治疗策略的评价[J].中华内科杂志,2006,45(9):784-785.
[11]Brennan AL,Andrianopoulos N,Duffy SJ,et al.Trends indoor-to-balloon time and outcomes following primary percuta-neous coronary intervention for ST-elevation myocardial infarc-tion:an Australian perspective[J].Internal Medicine Journal,2014,44(5):S160.
[12]董梦舒,徐慧琳,楼娟,等.急性ST段抬高型心肌梗死患者急诊PCI门-球时间影响因素分析[J].医学信息,2017,30(7):54-55.
[13]Yudi MB,Ramchand J,Farouque O,et al.Impact of door-to-balloon time on long-term mortality in high-and low-riskpatients with ST-elevation myocardial infarction[J].InternationalJournal of Cardiology,2016(224):72-78.
[14]Martin L,Murphy M,Scanlon A,et al.The impact on longterm health outcomes for STEMI patients during a period ofprocess change to reduce door to balloon time[J].EuropeanJournal of Cardiovascular Nursing,2016,15(3):e37-e44
[15]Tsukui T,Sakakura K,Taniguchi Y,et al.Determinants of shortand long door-to-balloon time in current primary percutaneouscoronary interventions[J].Heart Vessels,2018:33(5):498-506.
[2]徐泽升,王炳勋,宋志远,等.经桡动脉应用一根指引导管完成急诊左右冠状动脉造影及介入治疗的可行性[J].中国介入心脏病学杂志,2009,17(3):171-172.
[3]Zheng W,Cheuk-Man YU,Liu J,et al.Patients with ST-segment elevation of myocardial infarction miss out on early reper-fusion:when to undergo delayed revascularization[J].Journal ofGeriatric Cardiology Jgc,2017,14(8):524-531.
[4]Yudi MB,Ramchand J,Farouque O,et al.Impact of door-to-balloon time on long-term mortality in high-and low-risk pa-tients with ST-elevation myocardial infarction[J].InternationalJournal of Cardiology,2016(224):72-78.
[5]Latt H,Aung S,Kyaw K,et al.Coronary artery ectasia presenting with acute inferior wall myocardial infarction in a youngadult[J].Journal of Community Hospital Internal Medicine Per-spectives,2017,7(4):262-264.
[6]Wang R,Mei B,Liao X,et al.Determination of risk factors affecting the in-hospital prognosis of patients with acute ST seg-ment elevation myocardial infarction after percutaneous coronaryintervention[J].Bmc Cardiovascular Disorders,2017,17(1):243.
[7]Tra J,De BC,Van d WI,et al.Multicentre analysis of current ST-elevation myocardial infarction acute care pathways[J].OpenHeart,2017,4(1):e000458.
[8]中华医学会心血管病学分会.经皮冠状动脉介入治疗指南(2009)[J].中华心血管病杂志,2009, 30(1):55-64.
[9]李钧,陈天葆.麻醉前谈话的方法和技巧[J].中国医学伦理学,2010,23(3):37-38.
[10]霍勇,陈明.急性ST段抬高心肌梗死介入治疗策略的评价[J].中华内科杂志,2006,45(9):784-785.
[11]Brennan AL,Andrianopoulos N,Duffy SJ,et al.Trends indoor-to-balloon time and outcomes following primary percuta-neous coronary intervention for ST-elevation myocardial infarc-tion:an Australian perspective[J].Internal Medicine Journal,2014,44(5):S160.
[12]董梦舒,徐慧琳,楼娟,等.急性ST段抬高型心肌梗死患者急诊PCI门-球时间影响因素分析[J].医学信息,2017,30(7):54-55.
[13]Yudi MB,Ramchand J,Farouque O,et al.Impact of door-to-balloon time on long-term mortality in high-and low-riskpatients with ST-elevation myocardial infarction[J].InternationalJournal of Cardiology,2016(224):72-78.
[14]Martin L,Murphy M,Scanlon A,et al.The impact on longterm health outcomes for STEMI patients during a period ofprocess change to reduce door to balloon time[J].EuropeanJournal of Cardiovascular Nursing,2016,15(3):e37-e44
[15]Tsukui T,Sakakura K,Taniguchi Y,et al.Determinants of shortand long door-to-balloon time in current primary percutaneouscoronary interventions[J].Heart Vessels,2018:33(5):498-506.