CAJ | 학술논문

目的探讨北京市急诊科胸痛患者就诊时间及急救车使用情况的调查.方法本研究属多中心前瞻性描述性研究,参研单位包括17所医院.使用统一表格记录入选患者的一般资料,包括既往病史、发病时间、到达医院急诊时间、胸痛特点、心电图描述及诊断、初步诊断、急诊的诊治情况、辅助检查、确定诊断和去向及就诊30 d后的临床转归情况.所有数据经SAS 8.2统计软件进行统计学处理.结果 2009年7-8月,在17个医疗中心连续有效入选至急诊室就诊的胸痛患者,计划纳入6000例,最终5666例患者确认获得有效记录而入选.年龄(58.1±18.4)岁,男性2663例,占47％,女性3003例,占52％;胸痛患者占急诊总量的4.7％.其中工作日为4.8％,非工作日为4.3％,占急诊内科量10.53％ (1.58％～11.66％),其中工作日为10.7％,非工作日为10.3％.胸痛患者就诊时间在0:00到8:00为8.7％,8:00到16:00为47.5％,16:00到24:00为43.8％.胸痛患者就诊患者13.8％使用救护车,其中AMI患者39％;自行就诊的患者86.2％.其中AMI患者61％.30 d随访结果,院外死亡37例(0.7％),再次入院275例(4.9％).结论我国患者的急救知识的宣传目前还很缺乏.积极完善急救系统也是目前势在必行,重视无胸痛患者和以伴随症状就诊的患者,正确地做出诊断,及时给予患者进行规范诊疗,降低患者的病死率.
목적 탐토북경시급진과흉통환자취진시간급급구차사용정황적조사.방법 본연구속다중심전첨성묘술성연구,삼연단위포괄17소의원.사용통일표격기록입선환자적일반자료,포괄기왕병사、발병시간、도체의원급진시간、흉통특점、심전도묘술급진단、초보진단、급진적진치정황、보조검사、학정진단화거향급취진30 d후적림상전귀정황.소유수거경SAS 8.2통계연건진행통계학처리.결과 2009년7-8월,재17개의료중심련속유효입선지급진실취진적흉통환자,계화납입6000례,최종5666례환자학인획득유효기록이입선.년령(58.1±18.4)세,남성2663례,점47％,녀성3003례,점52％;흉통환자점급진총량적4.7％.기중공작일위4.8％,비공작일위4.3％,점급진내과량10.53％ (1.58％～11.66％),기중공작일위10.7％,비공작일위10.3％.흉통환자취진시간재0:00도8:00위8.7％,8:00도16:00위47.5％,16:00도24:00위43.8％.흉통환자취진환자13.8％사용구호차,기중AMI환자39％;자행취진적환자86.2％.기중AMI환자61％.30 d수방결과,원외사망37례(0.7％),재차입원275례(4.9％).결론 아국환자적급구지식적선전목전환흔결핍.적겁완선급구계통야시목전세재필행,중시무흉통환자화이반수증상취진적환자,정학지주출진단,급시급여환자진행규범진료,강저환자적병사솔.
Objective To identify the time of patients presented to the ER with chest pain or chest pain equivalent,and to further analyze the ambulance used by coronary heart disease patients in the ER.Methods We conducted a prospective,cross-sectinal survey of all patinets presented to the ER with chest pain and chest pain equivalent syndrome in 17 medical centres in Beijing,China from July to August 2009.Data was collected by structured interviews and medical record reviews.The mean follow up period was 30 days.Results A total of 5666 patients were enrolled in the study (age 58.09 ± 18.39,2663 males and 3303 females).Chest pain patients accounted for 4.7％ of total emergency,h weekday 4.8％,the non-working day 4.3％,10.53％ of internal emergency medicine (1.58％-11.66％),the working day 10.7％,non-working days 10.3％.Chest pain patients admitted at 0:00 to 8:00 accounted for 8.7％,8:00 to 16:00 47.5％,16:00 to 24:00 43.8％.About 13.8％ patients with chest pain used the ambulance (AMI patients 39％) ; 86.2％ patients were admitted to the hosptial without ambulance (AMI patients 61％).Conclusion The first aid knowledge publicity in our country is still very lack.Therefore,it is important to improve the emergency system,attaches great importance to the patients with chest pain and chest pain equivalen symptoms.