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目的评估胸痛微信群对急性ST段抬高型心肌梗死(STEMI)诊疗的影响。方法 2015年5月建立胸痛微信群。选择2015年5月至2016年4月经本院确诊STEMI的患者30例作为观察组,由首诊医师床边心电图检查、并上传至2015年5月建立的胸痛微信群,心内科医师网上会诊,确诊为STEMI后立即启动绿色通道,行急诊经皮冠状动脉介入治疗(PCI)。选择2013年5月至2015年4月本院急诊PCI的30例STEMI患者为对照组。比较两组患者入门到导管室时间(术前时间),导管室内至血管再灌注时间(手术时间),入门到球囊扩张时间(D-B时间),90和120min再灌注率。结果观察组术前时间(76.46±29.04)min和D-B时间(97.40±29.84)min均显著低于对照组(109.21±49.16)min和(134.56±49.01)min(均P<0.05)。120min再灌注率观察组(83.33%)显著高于对照组(40.00%),差异有统计学意义(χ2=11.92,P<0.05),观察组手术时间和90min再灌注率[(21.26±6.06)min,36.67%]与对照组接近[(25.36±9.68)min,20.00%]。结论应用胸痛微信群能明显缩短术前时间、D-B时间、提高120min再灌注率。
Objective To evaluate the effect of Weixiong group with chest pain on the diagnosis and treatment of acute ST-segment elevation myocardial infarction (STEMI). Methods May 2015 Establishment of WeChat Group of Chest Pain. Thirty patients diagnosed with STEMI in our hospital from May 2015 to April 2016 were selected as the observation group by bedside ECG examination of the first clinician and then uploaded to the WeChat group of chest pain established in May 2015. The online consultation of cardiologists, Immediate diagnosis of STEMI green channel, emergency percutaneous coronary intervention (PCI). Thirty STEMI patients in our hospital from May 2013 to April 2015 were selected as the control group. The time from entry to catheterization (preoperative), catheterization to vascular reperfusion (surgery), entry to balloon dilation (D-B), and reperfusion at 90 and 120 min were compared between the two groups. Results The preoperative time (76.46 ± 29.04) min and D-B time (97.40 ± 29.84) min in the observation group were significantly lower than those in the control group (109.21 ± 49.16) min and (134.56 ± 49.01) min (all P <0.05). The reperfusion rate at 120 min in the observation group (83.33%) was significantly higher than that in the control group (40.00%) (χ2 = 11.92, P <0.05). The operation time and the reperfusion rate at 90 min in the observation group were (21.26 ± 6.06) min, 36.67%] compared with the control group [(25.36 ± 9.68) min, 20.00%]. Conclusion Weixin group with chest pain can significantly shorten the preoperative time, D-B time and increase the reperfusion rate after 120 minutes.