Beijing, March 26 (Xinhuanet) -- For patients with chest pain who suddenly experience severe chest and back pain, the key to treatment is "fast". However, the treatment of ST-segment elevation myocardial infarction (STEMI) in China faces many problems, the most important of which is the patient's own causes and the time delay during the transfer process. On March 24, 2017, China Med opened in Beijing, and at the 2017 Regional Chest Pain Center Collaborative Treatment Development Seminar held at the same time, a number of well-known domestic experts made in-depth exchanges on important issues such as the construction of the regional collaborative network for chest pain and the construction of the primary medical emergency system. Liu Huiliang, vice president of the Armed Police General Hospital, pointed out that the construction of the National Chest Pain Center has entered a period of rapid development, and for the grass-roots level with a relatively low level of treatment, acute chest pain urgently needs coordinated treatment. The China Chest Pain Center Accreditation Committee plans to pass the chest pain center certification in 1,000 hospitals across the country in the next three years, of which about 500 are primary hospitals.
Seminar site
Chest pain first aid is not to be nearby, and the treatment hospital needs to have a chest pain center
Clinical causes of acute chest pain are complex, about 30% of patients are acute myocardial infarction, and the initial 120 minutes of the disease is regarded as the "golden time" for treatment, such as delay in treatment, the fatality rate, disability rate will be greatly increased, posing a serious threat to the patient's life.
Professor Wan Zheng, chief physician of the Department of Cardiology of the General Hospital of Tianjin Medical University, said that to change the way of first aid, several basic concepts must be changed, such as chest pain first aid is not equal to the nearest first aid, and it is necessary to go to the hospital that has the conditions to do thrombolysis and other treatments. The chest pain center is not equivalent to the "green channel" in the hospital; the construction of the chest pain center in the grass-roots hospital focuses on the change of concept. "We need to encourage grassroots hospitals to operate in the model of chest pain centers, not necessarily all of them meet the standards, first do a good job in key links, and then mature other standards little by little." It is also necessary to vigorously train grass-roots medical personnel and residents to recognize these concepts, and if they have chest pain, they must go to the hospital and call 120. Wan Zheng said.
Why is the emphasis on the construction of grassroots chest pain centers? The data show that more than 2/3 of the hospitals that treat patients with acute myocardial infarction early after the onset of the disease are in grass-roots hospitals, and the grass-roots level has become the main battlefield for the treatment of acute myocardial infarction. Another set of data shows that as of the end of 2016, there were only 122 hospitals certified by chest pain centers, of which only 5 were primary chest pain centers.
Professor Song Xiantao, chief physician of the Department of Cardiology of Beijing Anzhen Hospital, said that the ability of grass-roots doctors to treat is limited, dozens of diseases will lead to chest pain attacks, which diseases will be fatal, need rapid treatment, and require rapid differential diagnosis and treatment preparations by doctors and hospitals for the first time. For example, if the patient is suspected of chest pain caused by dissection of the large blood vessel artery, many hospitals do not have the treatment conditions and need to make a quick judgment and transport it in time. Song Xiantao stressed that there are many implementation paths for the construction of grass-roots chest pain centers, but the construction of individualized grass-roots chest pain centers should be implemented in combination with the specific conditions of different regions. Among them, two-way referral is an important foundation for the construction of grass-roots chest pain centers, which requires multi-departmental and multidisciplinary collaboration to complete.
Professor Su Xi, vice president of the Affiliated Hospital of Wuhan University and Wuhan Asian Heart Hospital, said that the integrated treatment of PCI hospitals and grass-roots hospitals, that is, the construction of regional collaborative treatment system, is the key to shortening the efficiency of early reperfusion treatment time. The model is based on hospitals with emergency PCI capabilities as the core, the surrounding non-PCI hospitals as part of the whole, into the unified management of regional chest pain centers, through the transmission of ECG between hospitals, ambulances and hospitals to complete the early diagnosis after the first medical contact, by PCI hospital guidance or in coordination with non-PCI hospitals to determine reperfusion treatment strategies and referral programs. The establishment of a regional coordinated treatment system will be an inevitable trend in the treatment of acute myocardial infarction in China in the future, and the participation and policy support of health administrative departments at all levels can better promote the establishment of the system.
Li Weiguo, vice president of Jinzhou Central Hospital, said in introducing the "Jinzhou Model" that with the support and overall coordination of the local Municipal Health and Family Planning Commission, with the chest pain center of Jinzhou Central Hospital as the core, through the unified deployment of the cardiovascular accident emergency system (BK-iED) for the city 120 and primary medical institutions, jointly participated in the construction of the chest pain center, and built a collaborative treatment network for acute myocardial infarction in Jinzhou.
The construction of network regionalized collaborative intelligent diagnosis and treatment platform is an important support
With the rapid development of big data, cloud computing, and the Internet of Things, informatization has provided important support for the development of primary medical care.
Xing Chunxiao, deputy dean of the Institute of Information Technology of Tsinghua University, said that Tsinghua University established a medical and health engineering research center in 2013, mainly aiming at three research directions: medical and health decision support system (DSS), health Internet of Things, and medical and health cloud computing platform. In 2015, Tsinghua University and Beacon Technology jointly established the Smart Health Big Data Joint Center, which has done a lot of research work around mobile Internet of Things technology and data management and analysis technology, and developed and designed a networked and intelligent regional collaborative treatment system for acute myocardial infarction based on mobile Internet and cloud computing technology on the basis of Huading cloud platform technology, hoping to provide a solution for grassroots people to see a doctor through the collaborative diagnosis and treatment technology platform of the chest pain center in the region.
According to reports, the Armed Police General Hospital, together with Tsinghua University and Beacon Technology, has established a STEMI regional collaborative treatment system in western Beijing, which will be incorporated into 14 PCI hospitals in western Beijing, a number of non-PCI medical institutions and regional EMS systems, forming a networked and intelligent regional collaborative treatment information platform and terminal. For example, the chest pain center can move the tentacles of diagnosis and treatment to the first scene of the disease through mobile medical means such as real-time transmission of pre-hospital medical data and remote diagnosis. Once the myocardial infarction abnormality is found, the chest pain center can make a judgment in advance and mobilize the pre-hospital emergency system to respond in advance, so that the chest pain prevention and treatment front is moved forward to the front of the hospital, better preventing the occurrence of sudden cardiac infarction tragedy. Lu Yang, director of the Business Department of Beacon Science and Technology Innovation, said that through the use of Internet medical technology and the implementation of intelligent diagnosis and treatment information technology, the emergency management covering pre-hospital EMS, the treatment management of non-PCI primary hospitals, PCI central hospitals, and the management of cardiac rehabilitation treatment after discharge from the hospital is integrated, patient-centered, and the overall solution for acute coronary syndrome (ACS) from prevention, first aid, diagnosis and treatment to rehabilitation is formed.