Di Pede F, Raviele A
Laboratorio di Emodinamica, U.O. di Cardiologia, Dipartimento Cardiovascolare, Ospedale Umberto I, Mestre-Venezia.
Ital Heart J Suppl. 2001 Jan;2(1):26-30.
In centers without hemodynamic laboratories the quality of medical care may be suboptimal since the unavailability of these technologies may reduce medical experience in the treatment of heart disease, mostly in acute coronary syndromes, and may increase the need for referring some patients to other hospitals. The problem will be of great relevance in the case of expansion of the aggressive approach in the treatment of acute ischemic syndromes such as acute myocardial infarction and unstable angina. The impelling need for small centers of improving medical care may promote the spontaneous and uncontrolled proliferation of hemodynamic laboratories. The high number of hemodynamic laboratories may lead to a low institutional volume and, as a consequence, may negatively influence the outcome of coronary intervention and increase health care costs. The experience of operators and the costs are probably more relevant as regards angioplasty than coronary angiography. Therefore we propose the implementation of departments of interventional hemodynamic laboratories including different hospitals: diagnostic laboratories will be allocated in hospitals with coronary care units, while interventional laboratories will be allocated in referring hospitals.
在没有血流动力学实验室的医疗中心，医疗质量可能欠佳，因为这些技术的缺乏可能会减少心脏病治疗方面的医疗经验，尤其是在急性冠状动脉综合征方面，并且可能会增加将一些患者转诊至其他医院的需求。在扩大对急性缺血性综合征（如急性心肌梗死和不稳定型心绞痛）的积极治疗方法时，这个问题将具有重大相关性。小型医疗中心迫切需要改善医疗服务，这可能会促使血流动力学实验室自发且不受控制地增多。血流动力学实验室数量过多可能导致机构工作量不足，进而可能对冠状动脉介入治疗的结果产生负面影响，并增加医疗成本。就血管成形术而言，操作人员的经验和成本可能比冠状动脉造影更为重要。因此，我们建议在不同医院设立介入血流动力学实验室部门：诊断实验室将设在设有冠心病监护病房的医院，而介入实验室将设在转诊医院。
