急诊路径管理模式对心源性休克患者应用体外膜肺氧合抢救时效的影响研究  

Effects of emergency pathway management mode on the using of extracorporeal membrane oxygenation rescue timeliness in patients with cardiogenic shock

作　　者：解文红 张莉 XIE Wenhong;ZHANG Li(Department of Emergency Medicine,Xijing Hospital,the First Affiliated Hospital of People’s Liberation Army of China Air Force Medical University,Xi’an Shaanxi 710032,China)

机构地区：[1]中国人民解放军空军军医大学第一附属医院(西京医院)急诊科,陕西西安710032

出　　处：《中国急救复苏与灾害医学杂志》2025年第4期534-537,共4页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的 探讨急诊路径管理模式对心源性休克(CGS)患者应用体外膜肺氧合(ECMO)抢救时效的影响。方法 回顾性选取2021年10月—2024年10月中国人民解放军空军军医大学第一附属医院收治的行ECMO救治的150例CGS患者,根据收治时间的先后分为对照组(2021年10月—2023年3月,67例)与观察组(2023年4月—2024年10月,83例),对照组予以常规急诊护理模式,观察组予以急诊路径管理模式。比较两组的抢救时效(ECMO团队到达时间、护士备物时间、ECMO上机时间)、抢救效果(住院时间、抢救成功率)、并发症发生率、护理满意度。结果 观察组ECMO团队到达时间、护士备物时间及ECMO启动时间均短于对照组(t=9.214、7.977、26.408,均P<0.05)。两组抢救成功率均为100.00%,但观察组的住院时间短于对照组(t=10.587,P<0.05)。观察组的并发症总发生率为7.23%,较对照组17.91%更低(χ^(2)=4.006,P<0.05)。与对照组相比,观察组的满意度更高(χ^(2)=6.629,P<0.05)。结论 急诊路径管理模式应用于CGS患者中可提高ECMO抢救时效和满意度,缩短住院时间,降低并发症发生率。Objective To explore the impact of emergency pathway management on the timeliness of extracorporeal membrane oxygenation(ECMO) rescue in patients with cardiogenic shock(CGS).Methods A total of 150 patients with CGS undergoing ECMO treatment in the First Affiliated Hospital of People's Liberation Army of China Air Force Medical University were retrospectively enrolled between October 2021 and October 2024.According to different admission time,they were divided into control group(67 cases,October 2021-March 2023) and observation group(83cases,April 2023-October 2024).The control group was given routine emergency nursing mode,while observation group was given emergency pathway management mode.The rescue timeliness(arrival time of ECMO team,preparation time of nurses,ECMO booting time),rescue effect(hospitalization time,success rate of rescue),incidence of complications and nursing satisfaction were compared between the two groups.Results The arrival time of ECMO team,preparation time of nurses and ECMO booting time in observation group were shorter than those in control group(t=9.214,7.977,26.408,all P<0.05).The success rates of rescue in the two groups were both 100%,but length of hospitalization time in observation group was shorter than that in control group(t=10.587,P<0.05).The total incidence of complications in observation group(7.23%) was lower than that in control group(17.91%)(χ^(2)=4.006,P<0.05),and satisfaction was higher than that in control group(χ^(2)=6.629,P<0.05).Conclusion The application of emergency pathway management mode can improve ECMO rescue timeliness and satisfaction of CGS patients,shorten length of hospitalization time and reduce the incidence of complications.

关 键 词：心源性休克 急诊路径管理模式 体外膜肺氧合 抢救时效 

分 类 号：R473.5[医药卫生—护理学]