Qianjiang Evening News Hourly News Reporter He Lina Correspondent Wu Zeyu
On a construction site in Yuhang, Hangzhou, 50-year-old Wu (pseudonym) went to work as usual, and when he rested and chatted, he was still an active member of the worker group, listening to his thick northeast cavity, as if he had humor in his genes. In the bursts of laughter, everyone seems to have forgotten that two months ago, Lao Wu suddenly fainted at work and almost said goodbye to them forever.
Lao Wu's fainting is due to the dangerous acute heart failure, cardiogenic shock, and his mortality rate is even higher than that of myocardial infarction. The reason why he was able to escape the disaster and recover quickly as before was due to the fact that Hangzhou is vigorously promoting the construction of chest pain treatment units.
What is a chest pain treatment unit? What can it bring to the people? Professor Zhang Xingwei, Chairman of the Hangzhou Chest Pain Center Alliance, President of the Affiliated Hospital of Hangzhou Normal University, and expert in cardiovascular medicine, demonstrated the far-reaching significance of their efforts to open up the "first kilometer" of life channels by restoring Lao Wu's treatment experience.
Middle-aged men suddenly have heart failure
After 11 days, he was discharged from the hospital on his own
Old Wu is a native of Jilin and has worked alone in Hangzhou for many years, although he has reached middle age, he is still full of confidence in his own health, and he is always reluctant to lose to young people when he works on the construction site.
One day in early October, Lao Wu suddenly felt chest tightness, impatience, and sweating heavily while working. He thought that it was because he was a little tired from working in the morning, and then looked at the time that it had reached 11 o'clock at noon, thinking that he would hold on for a while, and when he took a break at noon, he did not pay attention to it, and continued to work at noon. Until more than 3 p.m., he only felt that his chest tightness had worsened, and then he fainted, and when he woke up, he was lying in the rescue room of the Hangzhou Normal University Annex.
After Lao Wu fainted, he was sent to the nearest Renhe Street Community Health Service Center by the workers for the first time, and the receiving doctor initially determined that it was a cardiovascular accident, while treating the symptoms according to the treatment method of cardiovascular critically ill patients, he called 120 while docking the Chest Pain Center of the Affiliated Hospital of Hangzhou Normal University.
At 4 o'clock in the afternoon, the on-duty medical staff of the Chest Pain Center of the Affiliated Hospital of Hangzhou Normal University had made all preparations, and as soon as the ambulance arrived, Lao Wu was sent to the rescue room. At that time, Lao Wu's lips were white, his breathing was weak, his heart was slow, he was unconscious, and he was typical of cerebral ischemia and hypoxia. The receiving doctor performed tracheal intubation, cardiopulmonary resuscitation at the first time, and after the vital signs were slightly stable, the emergency department did coronary angiography, determined that the blood vessels were not occluded, excluded myocardial infarction, and then did a cardiac ultrasound, found that the heart was huge, and the EF value (left ventricular ejection fraction of heart function) was only 1/3 of normal people, the diagnosis was acute heart failure, and it was immediately transferred to the ICU for treatment.
Lao Wu recovered quickly, removed the tracheal intubation the next day in the ICU, lived for 3 days and was transferred to the general ward, and then recovered from the hospital in only 11 days through a series of rehabilitation treatments such as cardiac function correction and respiratory recovery. That day, he walked out of the hospital by himself, excitedly pulling the medical staff for a group photo.
According to the "China Cardiovascular Health and Disease Report (2020)", the prevalence and mortality rate of cardiovascular disease in China continue to rise, which has become a major public health problem. Autumn and winter is a high incidence of cardiovascular accidents, the emergency department of major hospitals is admitted almost every day, and the tragedy of being rescued to leave a disability or not being saved occurs from time to time, and Lao Wu is undoubtedly lucky.
Promote the construction of chest pain treatment units
Open up the "first kilometer" of life channels
"For patients with cardiovascular accidents such as heart failure and myocardial infarction, whether they can seize the golden rescue time is directly related to life and death. When myocardial ischemia ischemia is 3 hours, the cardiomyocytes partially die, while when the myocardial ischemia ischemia for 6 hours, the cardiomyocytes die completely. In recent years, major hospitals have built chest pain centers to minimize the treatment time and save lives. Professor Zhang Xingwei said.
In November 2011, the Affiliated Hospital of Hangzhou Normal University established a remote real-time ECG monitoring and transmission network with various community health service centers in Gongshu District, and set up a green channel for heart disease treatment between the community and the hospital. In early 2015, it took the lead in preparing for the construction of a chest pain center in the province, passed the certification of the standard version of the chest pain center in July 2016, passed the certification of the demonstration base of the China Chest Pain Center in December 2017, led the establishment of the Hangzhou Chest Pain Center Alliance in the same year, and led the establishment of the Chest Pain Branch of the Hangzhou Medical Association in November 2018. He has accumulated rich experience in the rapid, accurate and effective treatment of cardiovascular accident patients. Taking myocardial infarction as an example, from the admission of patients to the completion of surgery, the average time spent 10 years ago was 180 minutes, and now it has been shortened to 60 minutes, and the shortest time for a patient is only 29 minutes, which greatly improves the prognosis of patients and reduces the burden on families and society.
However, this protective net that guards the public's heart is not big enough. According to Professor Huo Yong, director of the World Heart Alliance and executive chairman of the China Chest Pain Center Alliance, as the closest professional medical resource to the people, the grass-roots community hospitals largely undertake the task of receiving urgent chest pain, but most of the chest pain center system is still limited to medical institutions in the central urban area, and the grass-roots community hospitals lack equipment, personnel and technical conditions to play the role of the chest pain center. The chest pain treatment unit is in accordance with the principle of proximity, the grass-roots community hospital and the certified chest pain center to establish a joint treatment and referral relationship, timely and accurate diagnosis of chest pain patients, thereby reducing the delay of early treatment and improving the treatment rate.
Professor Zhang Xingwei said that since the construction of chest pain treatment units was launched at the national level in 2020, the Hangzhou Chest Pain Center Alliance has also continued to promote this work. The construction of chest pain treatment units is not a simple listing, from the sorting out of the treatment process to the training of grass-roots medical care, and even the popularization of science for residents in the jurisdiction, etc., it is necessary for doctors and patients to jointly improve their awareness of chest pain in order to win time in the race against death. A series of treatments during the period of Lao Wu's coma, from the grass-roots community hospital to the large hospital with rescue capacity, took only 1 hour, which is crucial for prognosis.
At present, there are 8 chest pain treatment units in Hangzhou that have passed the acceptance, and there are more than 10 treatment units under construction, such as the Gongchenqiao Street Community Health Service Center, the Xiaohehushu Street Community Health Service Center, the Daguan Shangtang Street Community Health Service Center, the Banshan Street Community Health Service Center, the Harmony Street Community Health Service Center and many other qianyue hourly health stations are about to pass the acceptance. By accelerating the construction of chest pain treatment units, the rescue system area is extended to the grass-roots level, and the "first kilometer" of acute chest pain treatment is opened.
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