系统化护理流程干预对急性缺血性脑卒中患者急救效果及预后的影响  

Effects of systematic nursing process intervention on emergency treatment and prognosis of patients with acute ischemic stroke

作　　者：林晓霞[1] 木冬妹[1] 张巧萍[1] 谢嫦嫦 李丹东 Lin Xiaoxia;Mu Dongmei;Zhang Qiaoping;Xie Changchang;Li Dandong(Department of Neurosurgery,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,Zhejiang,China)

机构地区：[1]温州医科大学附属第二医院神经外科,浙江温州325000

出　　处：《中国中西医结合急救杂志》2021年第3期343-346,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：浙江省医药卫生科技计划项目(2020KY646)。

摘　　要：目的探讨系统化护理流程干预对急性缺血性脑卒中患者急救效果及预后的影响.方法回顾分析2018年1月至2020年1月在温州医科大学附属第二医院就诊的缺血性脑卒中患者的临床资料,以2018年1月至12月实施常规急救流程期间收治的患者作为对照组,以2019年1月至2020年1月实施系统化护理流程期间收治的患者作为研究组.对照组采取常规急救流程;研究组采取系统化标准护理流程干预急救,包括成立急救护理小组、对患者进行急救准备和评估、急诊全面监测和治疗、并发症护理以及康复期健康教育.记录两组患者的确诊时间、静脉开通时间、CT检查时间、入院溶栓时间.自制护理满意度调查问卷,评估患者家属对本次护理的满意度,记录两组患者急救效果及预后并发症发生情况.结果共120例患者入选,研究组和对照组各60例.研究组患者各项急救时间均较对照组明显缩短〔确诊时间(min):15.02±3.02比21.21±3.46,静脉开通时间(min):9.01±1.82比13.37±3.02,CT检查时间(min):26.90±7.34比33.80±7.44,入院溶栓时间(min):54.40±10.22比62.33±7.49,均P<0.05〕,且研究组溶栓患者比例明显高于对照组〔81.67%(49/60)比51.67%(31/60),P<0.05〕.研究组各项护理满意度评分均明显高于对照组〔医患沟通(分):8.73±1.22比6.38±2.63,接诊科室处理(分):8.32±1.32比7.37±1.29,转运中护理(分):8.19±1.72比7.02±1.08,治疗后护理(分):9.03±0.73比7.87±0.94,均P<0.05〕.研究组患者总体预后不良率明显低于对照组〔43.33%(26/60)比81.67%(49/60),P<0.05〕.结论系统化护理流程能够显著缩短急性缺血性脑卒中患者的急救时间,提高急救效果,改善患者预后,提高护理满意度,具有较好的临床应用价值.Objective To explore the influence of systematic nursing process intervention on the emergency rescue effect and prognosis of patients with acute ischemic stroke.Methods The clinical data of patients with ischemic stroke who were treated in the Second Affiliated Hospital of Wenzhou Medical University from January 2018 to January 2020 were analyzed retrospectively.The patients treated with the routine emergency nursing process from January to December 2018 were in the control group,and the patients taken care by the systematic nursing process from January 2019 to January 2020 were assigned in the study group.The control group took the routine emergency procedure;the study group adopted the systematic and standardized nursing process to intervene in emergency rescue treatment,including the establishment of emergency nursing group,emergency preparation and evaluation of patients,comprehensive emergency monitoring and treatment,nursing for patients'complications and health education in their rehabilitation period.The time of confirmed diagnosis,vein opening,CT examination and thrombolysis after admission was recorded in the two groups.The self-made questionnaire concerning nursing satisfaction was made to evaluate the satisfaction degree of the patients'family members on the present nursing,and the emergency effect,prognosis and occurrence of complications of the two groups were recorded.Results A total of 120 cases patients were enrolled,60 cases in the study group and 60 cases in the control group.The first-aid time of various items for the patients in the study group was significantly shorter than that in the control group[confirmed diagnosis time(minute):15.02±3.02 vs.21.21±3.46,vein opening time(minute):9.01±1.82 vs.13.37±3.02,CT examination time(minute):(26.90±7.34 vs.33.80±7.44),the time of admission to thrombolysis(minute):54.40±10.22 vs.62.33±7.49,all P<0.05],and the proportion of thrombolytic patients in the study group was significantly higher than that in the control group[81.67%(49/60)vs.51.67%(3

关 键 词：系统化护理流程 急性缺血性脑卒中 急救效果 预后 

分 类 号：R47[医药卫生—护理学]