急性脑卒中患者rt-PA溶栓期间FMEA护理干预效果研究  

Effect of FMEA nursing intervention in acute stroke patients during rt-PA thrombolysis

作　　者：刘霞 张晶 毛莉梅 LIU Xia;ZHANG Jing;MAO Li-mei(Department of Neurology,Xi'an Third Hospital,Xi'an 710018,Shaanxi,CHINA;Department of Emergency,Xi'an Ninth Hospital,Xi'an 710054,Shaanxi,CHINA)

机构地区：[1]西安市第三医院神经内科,陕西西安710018 [2]西安市第九医院急诊科,陕西西安710054

出　　处：《海南医学》2022年第17期2302-2305,共4页Hainan Medical Journal

基　　金：陕西省西安市卫生健康委员会青年培育项目(编号:2020qn06)。

摘　　要：目的探讨急性脑卒中患者重组组织型纤溶酶原激活剂(rt-PA)溶栓期间失效及效应分析模式(FMEA)护理的干预效果。方法选择西安市第三医院神经内科2020年1~12月收治的急性脑卒中患者100例,所有患者均接受rt-PA溶栓治疗,采用随机数表法将患者分为观察组和对照组各50例。对照组患者行常规护理,观察组患者行FMEA护理。护理至出院并随访4周,回院复查时比较两组患者的护理效果,记录护理前、护理出院后回院复查时患者的日常生活能力量表(ADL)、美国国立卫生院卒中量表(NIHSS)、血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)变化,统计住院及随访期间的并发症发生情况。结果观察组患者的意识恢复时间、肢体恢复时间及住院天数分别为(5.71±1.21)d、(8.56±2.09)d、(12.31±3.21)d,明显短于对照组的(7.69±1.34)d、(13.21±2.76)d、(18.17±3.87)d,差异均有统计学意义(P<0.05);护理后回院复查时,两组患者的ADL评分升高,且观察组的ADL评分为(60.31±5.09)分,明显高于对照组的(53.41±4.87)分,而NIHSS评分降低,且观察组的NIHSS评分为(8.79±2.01)分,明显低于对照组的(12.31±1.98)分,差异均有统计学意义(P<0.05);护理后回院复查时,两组患者的CRP、TNF-α、IL-6水平均降低,且观察组的CRP、TNF-α、IL-6水平分别为(5.19±0.87)mg/L、(21.41±3.21)ng/L、(7.51±0.98)ng/L,明显低于对照组的(7.68±0.96)mg/L、(34.41±4.09)ng/L、(13.45±2.31)ng/L,差异均有统计学意义(P<0.05);观察组患者的并发症发生率为4.00%,明显低于对照组的18.00%,差异有统计学意义(P<0.05)。结论急性脑卒中患者rt-PA溶栓期间FMEA护理能提高患者的日常生活能力,改善神经缺损状况,减轻炎症反应,减少并发症。Objective To explore the effect of nursing intervention of failure mode and effects analysis(FMEA)in patients with acute stroke during thrombolysis with recombinant tissue-type plasminogen activator(rt-PA).Methods A total of 100 patients with acute stroke treated in Department of Neurology,Xi'an Third Hospital from Janu-ary to December 2020 were selected.All patients were treated with rt-PA thrombolysis.The patients were randomly di-vided into an observation group and a control group,with 50 patients in each group.The patients in the control group re-ceived routine nursing,and the patients in the observation group received FMEA nursing.Nursing was performed until discharge,and the patients were followed up for 4 weeks.The nursing effects of the two groups were compared when re-turning to the hospital for re-examination.The daily living ability scale(ADL),the National Institutes of Health Stroke Scale(NIHSS),and serum tumor necrosis factorα(TNF-α),interleukin-6(IL-6),and C-reactive protein(CRP)changes were recorded before and after nursing.The complications during follow-up were observed.Results The conscious-ness recovery time,limb recovery time,and length of hospital stay in the observation group were(5.71±1.21)d,(8.56±2.09)d,and(12.31±3.21)d,respectively,which were significantly shorter than(7.69±1.34)d,(13.21±2.76)d,and(18.17±3.87)d in the control group(P<0.05).After nursing,the ADL scores of the two groups significantly increased,and the ADL score of the observation group was(60.31±5.09)points,which was significantly higher than(53.41±4.87)points of the control group;the NIHSS scores significantly decreased,and the NIHSS scores of the observation group was(8.79±2.01)points,which was significantly lower than(12.31±1.98)points of the control group;the differences were sta-tistically significant(P<0.05).After nursing,the levels of CRP,TNF-α,and IL-6 in the two groups were all decreased,and the levels in the observation group were(5.19±0.87)mg/L,(21.41±3.21)ng/L,(7.51±0.98)ng/L,which were signifi-

关 键 词：急性脑卒中 重组组织型纤溶酶原激活剂 失效及效应分析模式 炎性因子 神经功能 并发症 

分 类 号：R473.74[医药卫生—护理学]