COVID-19期间贵州省STEMI患者救治特征分析

目的 分析贵州省2020年1月21日—2月24日新冠疫情期间贵州省STEMI患者的救治特征，为疫情的防控、诊断、治疗及决策提供详实的数据基础与参考。方法：选取2020年1月21日—2月24日贵州省内的13所三级甲等教学医院心内科收治的STEMI患者作为实验组,这13所医院2019年同期收治的STEMI患者为研究对象作为对照组。记录所选13家医院的医院等级、胸痛中心及胸痛联盟认证情况,记录是否分属教学医院。记录所选对象的性别、年龄及慢性合并症情况。记录两组对象在各家医院的就诊数量、救治方式及并发症情况。记录患者的总缺血时间、发病-首次医疗接触、首次医疗接触-导丝通过及入门-导丝通过时间。结果:2020年1月21日—2月24日选取贵州省13所三甲医院,其中12所为胸痛中心标准版认证单位,13所均分属当地胸痛中心联盟、为教学医院。两组患者的性别、年龄、吸烟史及慢性病情况均无统计学差异。实验组溶栓患者数较对照组明显降低(P＜0.01),溶栓成功患者、急诊PCI患者,心衰与死亡患者数目两组均无差异。实验组总缺血时间、发病-首次医疗接触时间、首次医疗接触-导丝通过时间及入门-导丝通过时间均长于对照组(均P＜0.01)。结论: ,新冠疫情使贵州省STEMI患者的发病就诊时间明显延长,表现为总缺血时间、发病-首次医疗接触、首次医疗接触-导丝通过及入门-导丝通过时间的延长,错过溶栓时间窗患者比例增加;对总体溶栓成功、心衰、死亡患者数目没有明显影响。

A analysis of treatment characteristics of STEMI patients in Guizhou Province during COVID-19

Objective To analyze the characteristics of the treatment of STEMI patients in Guizhou Province during the COVID-19 from January 21 to February 24, 2020, and provide a detailed data basis and reference for the prevention, control, diagnosis, treatment and decision-making of the epidemic. Methods: The STEMI patients admitted to the cardiology department of 13 First class hospital s in Guizhou province from January 21 to February 24, 2020 were selected as the experimental group. The STEMI patients admitted to the same hospital in the same period in 2019 as the Control group. Record the hospital level, chest pain center and chest pain alliance certification of the 13 hospitals, and record whether they belong to the teaching hospital. Record the sex, age and chronic comorbidities of the selected subjects. Record the number of treatments, treatment methods and complications of the two groups of patients in each hospital. Record the patient''s total ischemic time, onset-first medical contact, first medical contact-guide wire passage and entry-guide wire passage time. Results: From January 21 to February 24, 2020, 13 First class hospitals in Guizhou Province were selected, 12 of which were certified units of chest pain centers, and 13 of them were all affiliated with the local chest pain center alliance and teaching hospitals. There were no statistical differences between the two groups in gender, age, smoking history and chronic disease. The number of thrombolytic patients in the experimental group was significantly lower than that in the control group (P <0.01). There was no difference between the two groups in patients with successful thrombolysis, emergency PCI patients, heart failure and death patients. The total ischemia time, onset-first medical contact time, first medical contact-guide wire passing time and entry-guide wire passing time of the experimental group were all longer than those of the control group (all P <0.01). Conclusion: The COVID-19 has significantly prolonged the time of treatment time for STEMI patients in GuiZhou province, manifested as total ischemia time, onset-first medical contact, first medical contact-guide wire passage and entry-guide wire passage time extension, missed thrombolysis The proportion of patients with time windows increased; there was no significant effect on the overall thrombolytic success, heart failure, and the prevalence of death.