胸痛区域协同救治体系的时效性研究
摘要
<正>据2017中国心血管病报告显示,急性ST段抬高型心肌梗死(STEMI)患者直接经皮冠状动脉介入治疗(PCI)高达55833例~([1])。我国城乡医疗差距甚大,大多数病人主要集中在农村地区,转诊此类患者形势严峻,原因是患者从发病到导丝通过的时间内,影响因素较多,机制尚未完全成熟的胸痛中心只缩短了院内再灌注时间,总体缺血时间无明显改善~([2])。基于社会信息化快速的发展,联合院内外的胸痛区域联合救治体系应运而生。区域协同救治体系即
引文
[1]陈伟伟,高润霖,刘力生,等.《中国心血管病报告2017》概要[J].中国循环杂志,2018,(1):1.
[2]NALLAMOTHU BK,BATES ER,HERRIN J,et al.Times to treatment in transfer patients undergoing primary percutaneous coronary intervention in the United States:National Registry of Myocardial Infarction(NRMI)-3/4 analysis[J].Circulation,2005,111(6):761-767.
[3]O'GARA PT,KUSHNER FG,ASCHEIM DD,et al.2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction:a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines[J].Circulation,2013,127(4):e362.
[4]KAHLON TS,BARN K,AKRAM MM,et al.Impact of pre-hospital electrocardiograms on time to treatment and one year outcome in a rural regional ST-segment elevation myocardial infarction network[J].Catheter Cardiovasc Interv,2017,89(2):245.
[5]TURNER G O.Early warning signs of heart attack:three decades of public and professional education in the Southwest Missouri Ozarks[J].Crit Pathw Cardiol,2003,2(2):118.
[6]ZHANG Q,ZHANG R Y,QIU J P,et al.Impact of different clinical pathways on outcomes of patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention:the RAPID-AMI study[J].Chin Med J(Engl),2009,122(6):636.
[7]中国胸痛中心认证工作委员会.中国胸痛中心认证标准(2015年11月修订)[J].中国介入心脏病学杂志,2016,(3):121.
[8]KHAN A,PHADKE M,LOKHANDWALA Y Y,et al.A Study of Prehospital Delay Patterns in Acute Myocardial Infarction in an Urban Tertiary Care Institute in Mumbai[J].J Assoc Physicians India,2017,65(5):24.
[9]ALEXANDER T,MULLASARI A S,NARUL A J.Developing a STEMI system of care for low-and middle-income countries:the STEMI-India model[J].Glob Heart,2014,9(4):419.
[10]王万虹,张荣林,高千,等.经济欠发达地区急诊PCI治疗急性ST段抬高型心肌梗死患者的D2B时间延误分析[J].东南大学学报(医学版),2012,3(6):739.
[11]Smolderen KG,Spertus JA,Nallamothu BK,et al.Health care insurance,financial concerns in accessing98care,and delays to hospital presentation in acute myocardial infarction[J].JAMA,2010,303(14):1392.
[12]NEHME Z,CAMERON P A,AKRA M M,et al.Effect of a mass media campaign on ambulance use for chest pain[J].Med J Aust,2017,206(1):30.
[13]王斌,王焱,叶涛,等.区域协同ST段抬高型心肌梗死救治网络建设探讨[J].中华心血管病杂志,2014,42(8):650.2018 12 29
[2]NALLAMOTHU BK,BATES ER,HERRIN J,et al.Times to treatment in transfer patients undergoing primary percutaneous coronary intervention in the United States:National Registry of Myocardial Infarction(NRMI)-3/4 analysis[J].Circulation,2005,111(6):761-767.
[3]O'GARA PT,KUSHNER FG,ASCHEIM DD,et al.2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction:a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines[J].Circulation,2013,127(4):e362.
[4]KAHLON TS,BARN K,AKRAM MM,et al.Impact of pre-hospital electrocardiograms on time to treatment and one year outcome in a rural regional ST-segment elevation myocardial infarction network[J].Catheter Cardiovasc Interv,2017,89(2):245.
[5]TURNER G O.Early warning signs of heart attack:three decades of public and professional education in the Southwest Missouri Ozarks[J].Crit Pathw Cardiol,2003,2(2):118.
[6]ZHANG Q,ZHANG R Y,QIU J P,et al.Impact of different clinical pathways on outcomes of patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention:the RAPID-AMI study[J].Chin Med J(Engl),2009,122(6):636.
[7]中国胸痛中心认证工作委员会.中国胸痛中心认证标准(2015年11月修订)[J].中国介入心脏病学杂志,2016,(3):121.
[8]KHAN A,PHADKE M,LOKHANDWALA Y Y,et al.A Study of Prehospital Delay Patterns in Acute Myocardial Infarction in an Urban Tertiary Care Institute in Mumbai[J].J Assoc Physicians India,2017,65(5):24.
[9]ALEXANDER T,MULLASARI A S,NARUL A J.Developing a STEMI system of care for low-and middle-income countries:the STEMI-India model[J].Glob Heart,2014,9(4):419.
[10]王万虹,张荣林,高千,等.经济欠发达地区急诊PCI治疗急性ST段抬高型心肌梗死患者的D2B时间延误分析[J].东南大学学报(医学版),2012,3(6):739.
[11]Smolderen KG,Spertus JA,Nallamothu BK,et al.Health care insurance,financial concerns in accessing98care,and delays to hospital presentation in acute myocardial infarction[J].JAMA,2010,303(14):1392.
[12]NEHME Z,CAMERON P A,AKRA M M,et al.Effect of a mass media campaign on ambulance use for chest pain[J].Med J Aust,2017,206(1):30.
[13]王斌,王焱,叶涛,等.区域协同ST段抬高型心肌梗死救治网络建设探讨[J].中华心血管病杂志,2014,42(8):650.2018 12 29