胸痛中心管理模式在急性肺动脉栓塞患者救治的作用

摘要

Objective: To explore the difference in acute pulmonary embolism before and after building a chest pain center. Methods: By referencing to the requirements certified by the International Chest Pain Center Association, the management system and procedures of the chest pain center in the hospital. The patients with acute pulmonary embolism before (n=51) and after (n=63) the establishment of the chest pain center were compared in terms of underlying diseases, diagnosis time, success rate of thrombolysis, average hospital stay, average hospitalization expense and case fatality rate in hospital. Results: Compared with those before the establishment of the chest pain center, the constituent ratio of underlying diseases and success rate of thrombolysis among patients after the establishment of chest pain center showed no obvious changes (P>0.05), but the diagnosis time was reduced by 42.2min (20.8%), the average hospital stay was decreased by 5.3d (30.3%), the average hospital cost was reduced by RMB 10556.31 yuan (21.0%), and the case fatality rate in hospital was lowered to 41.9% (P<0.01). Conclusion: The international chest pain center management mode can effectively reduce the therapeutic time of acute pulmonary embolism and significantly lower case fatality rate. Therefore, it is an effective method to control medical cost and improve service quality.%目的：研究胸痛中心建设前后急性肺动脉栓塞患者救治的差异。方法：参照国际胸痛中心协会认证的要求，建立该院胸痛中心的管理制度和流程。对胸痛中心成立前（n=51）和成立后（n=63）两组急性肺动脉栓塞患者的基础疾病、诊断时间、溶栓成功率、平均住院时间、人均住院费用及院内病死率进行比较。结果：与胸痛中心成立前比较，胸痛中心成立后患者的基础疾病构成比和溶栓成功率无明显变化（P>0.05），但诊断时间缩短了42.2min（20.8%），平均住院时间缩短了5.3d（30.3%），人均住院费用减少了10556.31元（21.0%），院内病死率明显降低（41.9%）（P<0.01）。结论：采用国际化胸痛中心管理模式，有效缩短了对急性肺动脉栓塞患者的救治时间、明显降低了病死率，是控制医疗费用和提高服务质量的有效方法。