36例突發(fā)致命性胸痛患者院前急救和轉(zhuǎn)運(yùn)效果觀察

黃紅俠　李春蘭　+于云

【摘要】 目的：探討院前急救和轉(zhuǎn)運(yùn)對(duì)突發(fā)致命性胸痛患者臨床救治效果的影響。方法：選取筆者所在中心急救流程優(yōu)化前后病例分別作為對(duì)照組、觀察組，統(tǒng)計(jì)分析兩組患者在發(fā)病至開(kāi)始治療的時(shí)間、發(fā)病至確診的時(shí)間、住院時(shí)間、治療后并發(fā)癥的情況、死亡率等觀察指標(biāo)的差異。結(jié)果：觀察組中轉(zhuǎn)時(shí)間、發(fā)病至開(kāi)始治療的時(shí)間、發(fā)病至確診的時(shí)間、住院時(shí)間均少于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；觀察組的并發(fā)癥發(fā)生率、死亡率均低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論：院前急救及轉(zhuǎn)運(yùn)對(duì)患者的救治起關(guān)鍵作用，優(yōu)化院前急救及轉(zhuǎn)運(yùn)能夠有效提高患者的救治幾率與質(zhì)量。

【關(guān)鍵詞】 突發(fā)致命性胸痛； 院前急救； 急診

doi：10.14033/j.cnki.cfmr.2017.30.011 文獻(xiàn)標(biāo)識(shí)碼 B 文章編號(hào) 1674-6805（2017）30-0022-03

Observation on the Effect of Pre-hospital First Aid and Transport in 36 Patients with Sudden Fatal Chest Pain/HUANG Hong-xia，LI Chun-lan，YU Yun.//Chinese and Foreign Medical Research，2017，15（30）：22-24

【Abstract】 Objective：To investigate the effect of pre-hospital first aid and transport on clinical treatment of sudden and fatal chest pain.Method：The patients in our center before and after the optimization of emergency procedures were selected as the control group and the observation group.The time of onset to begin treatment，the time of onset to diagnosis，the time of hospitalization，the postoperative complications，the mortality rate were observed and compared between the two groups.Result：The connecting time，the time of onset to begin treatment，the time of onset to diagnosis，the time of hospitalization of the observation group were less than those in the control group，the differences were statistically significant（P<0.05）.The incidence of complications and mortality in the observation group were lower than those in the control group，the differences were statistically significant（P<0.05）.Conclusion：Pre-hospital first aid and transshipment play a key role in the treatment of patients，to optimize the pre-hospital first aid and transport can effectively improve the patients treatment probability and quality.

【Key words】 Sudden fatal chest pain； Pre-hospital first aid； Emergency

First-authors address：Kunshan City Emergency Center，Kunshan 215300，China

胸痛是很常見(jiàn)的急診癥狀之一，約占急診內(nèi)科患者的20%～30%[1]。且急性胸痛的臨床表現(xiàn)多樣，病情各異，存在的危險(xiǎn)性有較大差別，嚴(yán)重程度也不一定與病情呈正相關(guān)關(guān)系[2]。其中急性心梗、主動(dòng)脈夾層、肺栓塞、自發(fā)性氣胸等四種致命性疾病，發(fā)病急、病情變化極快、死亡率極高[3]。對(duì)此類(lèi)患者，及時(shí)準(zhǔn)確判斷患者的病情，實(shí)施院前急救，并有效縮短轉(zhuǎn)運(yùn)時(shí)間，是提高突發(fā)致命性胸痛患者搶救成功率的關(guān)鍵所在[4]。

隨著網(wǎng)絡(luò)的發(fā)展，筆者所在中心對(duì)危重患者急救流程進(jìn)行了優(yōu)化。本研究將通過(guò)院前急救和轉(zhuǎn)運(yùn)流程優(yōu)化前后突發(fā)致命性胸痛患者的治療情況探討其臨床應(yīng)用效果。

1 資料與方法

1.1 一般資料

選取筆者所在中心急救流程優(yōu)化后2015年6月-2016年6月收治的突發(fā)性致命性胸痛患者36例為觀察組，優(yōu)化前患者36例為對(duì)照組。觀察組患者平均年齡為（56.35±6.24）歲，對(duì)照組患者平均年齡為（57.82±5.97）歲。經(jīng)統(tǒng)計(jì)分析，兩組患者在年齡、性別、病情嚴(yán)重程度等方面比較，差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05），具有可比性。