临床护理路径在急性心肌梗死患者中的应用

Application of clinical nursing pathway in patients with acute myocardial infarction

目的：探讨临床护理路径在急性心肌梗死（ AMI）患者行急诊冠状动脉介入治疗中的应用效果。方法将360例AMI患者随机分为观察组（ n＝180）和对照组（ n＝180），对照组采用传统方法进行护理，观察组按临床护理路径表进行护理。比较两组患者行冠脉支架介入手术的时间，平均住院天数，住院费用，患者对疾病相关知识的掌握程度和满意度。结果观察组患者入院至介入手术时间为（65±20）min，总住院费用为（59284．41±18387．85）万元，平均住院天数为（8．50±2．54）d，患者满意度为97．22％，护理文书书写合格率为95．59％；对照组分别为（80±19）min，（85569．99±125324．77）万元，（11．00±2．97）d，88．89％，85．18％，两组比较差异均具有统计学意义（t值分别为18．3745，28．8290，8．5658，χ2值分别为9．6716，11．4251；P＜0．01）。结论应用临床护理路径对急性心肌梗死患者进行护理，可减少患者住院天数，降低其住院费用，提高患者满意度；提高护理人员护理文书书写合格率，规避了护理工作风险。

Objective To explore the implementation effect of the clinical nursing pathway in patients with acute myocardialinfarction （ AMI） under emergency percutaneous coronary intervention .Methods A total of 360 cases of AMI were randomly divided into the control group （ n=180 ） and the observation group （ n=180 ） .The control group was nursed by the traditional method , while the observation group was nursed according to the clinical nursing pathway table .The operation time , the average days of hospitalization , hospitalization expenses, patients’ understanding of disease-related knowledge and satisfaction rate were compared between the two groups .Results The observation group , the time from admission to operation , the overall hospitalization expenses,the average of days of hospitalization ,patients’ satisfaction rate and qualified rate of nursing document writing were （65 ±20）min, （59 284.41 ±18 387.85） ten thousand yuan, （8.50 ±2.54） d,97.22% and 95.59%.While in the control group, the data were （80 ±19） min, （85 569.99 ±12 5324.77）ten thousand yuan,（11.00 ±2.97） d,88.89% and 85.18%, respectively, which showed statistically significant （ t =18.3745,28.829 0,8.5658;χ2 =9.671 6, 11.425 1,respectively;P 〈0.01）.Conclusions Nursing according to the clinical nursing pathway in patients with AMI can reduce the length of hospital stay and hospitalization expenses , improve the satisfaction of patients and the qualified rate of nursing document writing , and avoid the risk of nursing work .