医疗优先分级调派系统在急性心肌梗死患者院前救治中的应用

摘要

Objective The essay is going to discuss the difference of pre -hospital care to acute myocardial infarction (AMI) patients by Suzhou Emergency Center before and after the Medical Priority Dispatch System ( MPDS ) was implemented , and the prioritized emergency response to such patients.Methods Six hundred and forty-one AMI patients, who Suzhou Emergency Center had been involved in their pre -hospital treatment and transportation from January 2008 to January 2014 , were picked out as the objective to study .These patients were divided into MPDS group (389 cases, after Suzhou Emergency Center implemented MPDS ), and Comparison group (252 cases, before MPDS was implemented ) .The study compared the timeliness of ambulance on the run , re-transfer rate , door-to-balloon time, FMC time, etc.Results The average D -to-B time in PCI operations for MPDS group is (96.55 ±9.42)min, while that for the Comparison group is (118.57 ±10.54)min(P<0.01).Moreover, the average FMC time for MPDS group is (121.88 ±11.42)min, while that for the Comparison group is (164.13 ±19.55)min (P<0.01), which is obviously statistically significant. Two re-transfer cases of MPDS group , comparing 24 re-transfer cases in Comparison group , with P<0.01, is also statistically significant .Conclusion By providing pre-hospital care to AMI patients with MPDS, it can apparently reduce the time of patient care , and improve patients outcome .%目的：比较苏州应用医疗优先分级调派系统（ MPDS）前后急性心肌梗死患者院前救治的差异，探索急性心肌梗死患者院前急救的优先模式。方法将2008－01～2014－01苏州急救中心参与急救运送的急性心肌梗死患者共641例作为观察对象，根据使用MPDS前后分为MPDS组389例（使用MPDS后）与对照组252例（使用MPDS前）进行相关数据分析，比较出车及时性、再次转诊比例、门－球囊扩张（ D－to－B）时间、FMC时间等。结果 MPDS组实施PCI手术的D－to－B时间（96．55±9．42）min，显著低于对照组的（118．57±10．54）min（P＜0．05）。MPDS组FMC平均时间为（121．88±11．42） min，显著低于对照组的（164．13±19．55） min（ P＜0.01）。再次转诊例数MPDS组2例，明显小于对照组24例（ P＜0．01）。结论应用MPDS进行急性心肌梗死患者院前急救可以显著缩短医疗救助时间，改善预后。