QCC活动管理对AMI患者行急诊PCI手术时间、心功能和预后的影响  

Effect of QCC activity management on emergency PCI time,cardiac function and prognosis in AMI patients

作　　者：王娜 边春云 张心可 WANG Na;BIAN Chun-yun;ZHANG Xin-ke(ICU for Coronary Heart Disease,First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei,075000,China)

机构地区：[1]河北北方学院附属第一医院冠心病重症加强病房,河北张家口075000

出　　处：《心血管康复医学杂志》2024年第3期280-284,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

基　　金：河北省2021年度医学科学研究课题(20210091)。

摘　　要：目的:探究品管圈(QCC)活动管理对行经皮冠状动脉介入治疗(PCI)手术的急性心肌梗死(AMI)患者手术时间、心功能及预后的影响。方法:选择2021年1月至6月我院急诊科收治并接受PCI手术的148例AMI患者。按照院内管理方式不同,患者被分为对照组(74例)和QCC组(74例)。比较两组急诊滞留时间及手术时间、术后7d及14d心功能指标、患者满意度及术后6个月不良心血管事件情况。结果:与对照组比较,QCC组心电监测时间[(11.35±2.13)min比(9.14±1.86)min]、病情评估时间[(14.78±2.51)min比(10.12±2.28)min]、用药准备时间[(29.69±5.03)min比(22.65±4.52)min]及手术时间[(83.47±10.76)min比(62.18±10.03)min]均显著降低,P均=0.001。与对照组比较,术后14d QCC组左室射血分数(LVEF)[(46.42±2.52)%比(58.54±1.82)%]显著升高,左室收缩末期容积指数(LVESVI)[(33.05±3.47)ml/m^(2)比(28.22±2.49)ml/m^(2)]和左室舒张末期容积指数(LVEDVI)[(69.08±4.53)ml/m^(2)比(56.85±2.48)ml/m^(2)]显著降低,P均<0.01。QCC组总满意度显著高于对照组(93.24%比62.16%),术后6个月不良心血管事件发生率显著低于对照组(12.16%比36.49%),P均=0.001。结论:品管圈活动管理模式介入可优化临床PCI手术流程,显著缩短急诊滞留时间、手术时间,改善心功能,降低术后心血管不良事件发生率,且满意度较高,值得临床推广应用。Objective:To investigate the effect of quality control circle(QCC)activity management on operation time,cardiac function and prognosis in patients with acute myocardial infarction(AMI)undergoing percutaneous coronary intervention(PCI).Methods:A total of 148 AMI patients who admitted to the emergency department of our hospital and underwent PCI from January to June 2021 were selected.According to different hospital management patterns,patients were divided into control group(n=74)and QCC group(n=74).Emergency detention time,PCI time,cardiac function indexes at 7d and 14d after PCI,patient satisfaction and incidence of adverse cardiovascular events on six months after PCI were compared between two groups.Results:Compared with control group,there were significant reductions in ECG monitoring time[(11.35±2.13)min vs.(9.14±1.86)min],condition evaluation time[(14.78±2.51)min vs.(10.12±2.28)min],drug preparation time[(29.69±5.03)min vs.(22.65±4.52)min]and PCI time[(83.47±10.76)min vs.(62.18±10.03)min]in QCC group,P=0.001 all.Compared with control group on 14d after PCI,there was significant rise in left ventricular ejection fraction(LVEF)[(46.42±2.52)%vs.(58.54±1.82)%],and significant reductions in left ventricular end-systolic volume index(LVESVI)[(33.05±3.47)ml/m^(2)vs.(28.22±2.49)ml/m^(2)]and left ventricular end-diastolic volume index(LVEDVI)[(69.08±4.53)ml/m^(2)vs.(56.85±2.48)ml/m^(2)]in QCC group,P<0.01 all.Total satisfaction of QCC group was significantly higher than that of control group(93.24%vs.62.16%),and incidence rate of adverse cardiovascular events on six months after PCI was significantly lower than that of control group(12.16%vs.36.49%),P=0.001 both.Conclusion:QCC activity management intervention can optimize clinical PCI procedure,significantly shorten emergency detention time,operation time,improve cardiac function,reduce postoperative incidence rate of cardiovascular adverse events.It possesses high satisfaction and is worthy of clinical promotion and application.

关 键 词：心肌梗死 血管成形术 气囊 冠状动脉 护理 

分 类 号：R542.22[医药卫生—心血管疾病]