基于SWOT分析法引导的风险控制管理在动脉粥样硬化闭塞症患者中的应用研究  

Application of SWOT analysis-guided risk control management in patients with atherosclerotic obliterans

作　　者：苏伟 王美 马英豪 周娟 卢俊英 SU Wei;WANG Mei;MA Ying-hao;ZHOU Juan;LU Jun-ying(Department of Cardiothoracic Surgery,Chinese People's Liberation Army Rocket Force Characteristic Medical Center,Beijing,100088,China)

机构地区：[1]中国人民解放军火箭军特色医学中心胸心外科,北京100088 [2]中国人民解放军火箭军特色医学中心质量管理科,北京100088

出　　处：《心血管康复医学杂志》2025年第1期86-91,共6页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探究SWOT分析法引导的风险控制管理在动脉粥样硬化闭塞症(ASO)患者中的应用效果。方法:选择中国人民解放军火箭军特色医学中心2017年11月-2022年11月收治的105例ASO患者,采用分层随机法分为对照组(52例)与干预组(53例)。对照组采用常规护理,干预组采用SWOT分析法引导的风险控制管理。对比术后两组患者肾功能、术后恢复情况、心理状况、睡眠质量、疼痛、不良反应及护理满意度。结果:术后3d,与对照组相比,干预组患者胱抑素C(CysC)水平[(1.04±0.11)mg/L比(1.40±0.12)mg/L]、血清肌酐(Scr)水平[(70.70±6.48)μmol/L比(82.93±9.32)μmol/L]和尿蛋白[(2.38±0.13)g/L比(3.56±0.17)g/L]水平显著降低(P均<0.001);术后7d,与对照组相比,干预组不良反应发生率(7.55%比23.08%)以及焦虑自评量表(SAS)评分[(34.09±3.40)分比(39.50±3.12)分]、抑郁自评量表(SDS)评分[(24.42±3.34)分比(32.04±2.77)分]、匹兹堡睡眠质量指数(PSQI)评分[(7.09±1.48)分比(10.19±1.65)分]、视觉模拟评分(VAS)[(3.09±0.84)分比(4.33±1.15)分]显著降低,跛行距离[(2407.89±130.09)m比(1521.26±102.26)m]和术后踝肱指数[(0.87±0.03)比(0.62±0.04)]显著增加(P<0.05或<0.01);出院时,干预组护理满意度显著提高(92.45%比73.08%,P=0.008)。结论:SWOT分析法引导的风险控制管理可以有效减轻动脉粥样硬化闭塞症患者介入术对肾功能的损伤,降低患者疼痛感、改善负性情绪、睡眠情况,减少术后不良事件的发生。Objective:To investigate the application effect of strengths,weaknesses,opportunities and threats(SWOT)analysis-guided risk control management in patients with atherosclerotic obliterans(ASO).Methods:This randomized controlled study enrolled 105 ASO patients admitted in Chinese People's Liberation Army Rocket Force Characteristic Medical Center between November 2017 and November 2022.They were divided into control group(n=52,routine nursing)and intervention group(n=53,SWOT analysis-guided risk control management).Renal function,postoperative recovery,psychological status,sleep quality,pain,incidence of adverse reactions and nursing satisfaction were compared between two groups.Results:3 d after surgery,compared with patients in control group,those in intervention group had significant lower cystatin C(CysC)[(1.04±0.11)mg/L vs.(1.40±0.12)mg/L],serum creatinine(Scr)[(70.70±6.48)μmol/L vs.(82.93±9.32)μmol/L]and urinary protein[(2.38±0.13)g/L vs.(3.56±0.17)g/L](P<0.001 all);7d after surgery,compared with patients in control group,those in intervention group had significant lower incidence of adverse reactions(7.55%vs.23.08%),scores of self-rating anxiety scale(SAS)[(34.09±3.40)points vs.(39.50±3.12)points],self-rating depression scale(SDS)[(24.42±3.34)points vs.(32.04±2.77)points],Pittsburgh sleep quality index(PSQI)[(7.09±1.48)points vs.(10.19±1.65)points]and visual analogue scale(VAS)[(3.09±0.84)points vs.(4.33±1.15)points],and significant higher limp distance[(2407.89±130.09)m vs.(1521.26±102.26)m]and ankle-brachial index[(0.87±0.03)vs.(0.62±0.04)](P<0.05 or<0.01).After discharge,nursing satisfaction in intervention group was significantly higher than that of control group(92.45%vs.73.08%,P=0.008).Conclusion:SWOT analysis-guided risk control management could effectively reduce the damage of renal function caused by interventional surgery,reduce pain,improve negative emotion and sleep quality,and reduce incidence of adverse events after surgery in patients with arteriosclerosis obliterans.

关 键 词：闭塞性动脉硬化 护理 SWOT分析 

分 类 号：R543.5[医药卫生—心血管疾病]