经皮冠状动脉介入治疗护理模式改进实践与分析  

The practice and analysis of nursing mode of percutaneous coronary intervention

作　　者：刘莹[1] 彭岩松[1] 闵英[1] 孙宁[1] 韩雅玲[1] 

机构地区：[1]沈阳军区总医院心血管病研究所,辽宁沈阳110016

出　　处：《实用临床医药杂志》2014年第20期1-3,14,共4页Journal of Clinical Medicine in Practice

摘　　要：目的规范冠心病介入治疗护理方法,降低并发症发生率,提高冠心病介入治疗护理质量。方法成立由护士长为组长、高年资护士为组员的改进小组,制定具体改进计划,明确分工,提出问题,分析原因,拟定预期目标、实施方案和评价标准,历经20年16731例冠心病介入治疗患者,在改进过程中及时修正《心脏介入治疗术前术后护理常规》。结果手术依从性(%):改进前(88.5±2.4)改进后(95.5±1.0);住院时间(d):改进前(8.4±1.5)改进后(5.2±0.4);治疗耗时(h):改进前(112.0±12.0)改进后(53.0±14.3)。并发症发生情况(%):肺内感染改进前(17.6±2.5)改进后(2.4±1.1);造影剂反应改进前(17.5±10.6)改进后(3.1±0.1);血管迷走反射改进前(12.3±2.5)改进后(3.9±1.0);出血或血肿改进前(29.1±3.1)改进后(4.3±1.1);局部皮肤破损改进前(2.2±0.6)改进后(0.9±0.3);肺栓塞改进前5例改进后3例。结论《心脏病介入治疗术前术后护理常规》符合临床具体操作,是人性化、经验丰富的护理流程,其中包括13个单病种的介入治疗护理常规,可在实践中指导护士进行护理工作,有效降低了并发症发生率,提升了护理质量,取得了良好的PCI围术期护理效果。Objective To standardize coronary intervention methods of nursing,reduce the incidence of complications and improve quality of nursing in percutaneous coronary intervention.Methods Improved team led by head-nurse and senior nurses for the members was set up in order to develop specific improvement plans,clear division of labor,ask questions,analyze the causes,develop intending targets and implement plans and evaluate criteria. During the past 20 years,16,731 patients had percutaneous coronary intervention therapy. During the process,the book Routine Nursing of Interventional Treatment before and after Surgery was amended. Results The operation compliance was（88. 5 ± 2. 4） before improvement and（95. 5 ± 1. 0） after improvement; Hospital stay（d） was（8. 4 ± 1. 5） before improvement and（5. 2 ± 0. 4） after improvement. The treatment of time-consuming（h） was（112. 0 ± 12. 0） before improvement and（53. 0 ± 14. 3） after improvement. The complications of pulmonary infection was（17. 6 ± 2. 5） before improvement and（2. 4 ± 1. 1） after improvement; The contrast agent response was（17. 5 ± 10. 6） before improvement and（3. 1 ± 0. 1） after improvement; The vasovagal reflex was（1 2. 3 ± 2. 5） before improvement and（3. 9 ± 1.0） after improvement; Bleeding or hematoma was（2 9. 1 ± 3. 1） before improvement and（4.3 ± 1. 1） after improvement; Local skin damage was（2. 2 ± 0. 6） before improvement and（0. 9 ± 0. 3） after improvement; There were 5 cases with pulmonary embolism before improvement and 3 cases after improvement. Conclusion The book Routine Nursing of Interventional Treatment before and after Surgery has practical and specific operations including 13 individual treatments of disease with interventional nursing. It guides nurses to work in nursing practice,effectively reduces the incidence of complications,improves quality of nursing,and achieves satisfactory PCI nursing consequences.

关 键 词：经皮冠状动脉介入 护理模式 持续改进 护理 

分 类 号：R473.5[医药卫生—护理学]