危机管理模式对急性重症病毒性心肌炎合并急性肾衰竭患者急诊救治情况及心肾功能的影响  

Effects of crisis management model on emergency treatment and cardiorenal function of patients with acute severe viral myocarditis complicated with acute renal failure

作　　者：史慧珍 黄晓琴 SHI Huizhen;HUANG Xiaoqin(Department of Nephrology,Qinghai Communications Hospital,Xining Qinghai 810008,China)

机构地区：[1]青海省交通医院肾内科,青海西宁810008

出　　处：《中国急救复苏与灾害医学杂志》2022年第2期230-233,242,共5页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的分析危机管理模式对急性重症病毒性心肌炎合并急性肾衰竭患者急诊救治情况及心肾功能的影响。方法回顾性收集2016年7月—2020年11月青海省交通医院肾内科收治的急性重症病毒性心肌炎合并急性肾衰竭患者108例临床资料,根据护理管理方式的不同,将2016年7月—2018年5月收治的患者纳为对照组,2018年6月—2020年11月收治的患者纳为危机管理模式组,各54例。对照组采用常规护理管理进行干预,危机管理模式组采用危机管理模式进行干预。比较两组急诊救治情况、心肾功能、并发症及复发、满意度。结果危机管理模式组住院和救护时间短于对照组,救治成功率高于对照组(P<0.05)。干预后,危机管理模式组血清心肌肌钙蛋白I(CTnI)、肌酸激酶同工酶MB(CK-MB)、尿素氮(BUN)、血肌酐(Scr)水平,心律均降低,收缩压、尿量均升高,危机管理模式组高于对照组(P<0.05)。危机管理模式组并发症发生率、复发率低于对照组(11.11%vs 29.63%,1.85%vs 14.81%,P<0.05)。危机管理模式组护理满意度为97.33%,对照组为86.67%,危机管理模式组高于对照组(P<0.05)。结论与常规护理管理模式相比,危机管理模式应用在急性重症病毒性心肌炎合并急性肾衰竭的急诊护理,能提高急诊救治效果,改善患者心肾功能,降低并发症及疾病复发风险,提高患者预后,获得患者及家属认可。Objective To investigate the effect of crisis management mode on emergency treatment and cardio-renal function of patients with acute severe viral myocarditis complicated with acute renal failure.Methods patients with acute severe viral myocarditis complicated with acute renal failure were hospitalized and undergo conventional treatment from July 2016 to November 2020.Those hospitalized from July 2016 to May 2018 underwent routine nursing care,and 54 patients were randomly collected from them as control group;those hospitalized from June 2018 to November 2020 underwent nursing care of crisis management model,and 54 were randomly collected from them as crisis management model group.Peripheral blood samples were collected at admission and 7 days after treatment to test the levels of cardiac troponin I(cTnI)and creatine kinase-MB(CK-MB)by immunosuppression,and levels of blood urea nitrogen(BUN)and serum creatinine(Scr)by enzyme kinetics.The clinical effects were recorded.Results The hospital stay of the crisis management model group was(5.08±1.18)d,and rescue time of the crisis management model group was(3.25±0.84)d,both significantly shorter than those of the control group[(6.72±1.32)d and(4.87±1.17)d respectively,both P<0.05].The success rate of treatment of the crisis management model group was 96.30%,significantly higher than that of the control group(P<0.05).After intervention,the levels of serum cTnI,CK-MB,BUN,and SCR,and heart rate of these 2 groups all decreased,and those of the crisis management model group were all significantly lower than those of the control group all(P<0.05)and the systolic blood pressure and urine volume of these 2 groups all increased,and those of the crisis management model group were both significantly higher than those of the control group(both P<0.05).The complication rate and recurrence rate of the crisis management model group were lower(11.11%vs 29.63%,1.85%vs 14.81%,both P<0.05).The nursing satisfaction of the crisis management model group was 97.33%,significantly higher t

关 键 词：危机管理 重症 病毒性心肌炎 急性肾衰竭 心肾功能 急诊 

分 类 号：R473[医药卫生—护理学]