评判性思维在阿托品化观察中的应用

Application of critical thinking in the atropinization

目的：探讨护士应用评判性思维对阿托品化进行观察的临床效果。方法选取2012年1-12月重度有机磷中毒患者120例，随机分为对照组和观察组各60例，对照组根据常规阿托品化指征进行观察与护理，观察组应用评判性思维对阿托品化进行观察与判断。比较两组患者阿托品化误判率、并发中间综合征发生率及平均住院时间。结果对照组患者阿托品化误判率为30．0％，观察组为10.0％，两组比较差异有统计学意义（χ2＝7．50，P＜0．01）；对照组患者并发中间综合征13例（21．7％），观察组5例（8．3％），两组比较差异有统计学意义（χ2＝4．18，P＜0．05）；观察组患者平均住院时间为（11．25±2．14）d，低于对照组（13．41±2．57）d，差异有统计学意义（t＝0．1209，P＜0．05）。结论在重度有机磷中毒患者阿托品化观察过程中，应用评判性思维模式，可降低阿托品化误判率，减少并发症的发生，并可缩短患者住院时间，减轻患者住院负担。

Objective To explore the clinical effect of critical thinking in the observation of atropinization in nurses .Methods One hundred and twenty severe organophosphorus poisoning patients from January 2012 and December 2012 were chosen and randomly divided into the control group and the observation group , each with 60 cases.The control group received the routine observation and nursing according to the indications of atropinization, and the observation group received the observation and judgment of atropinization through the application of critical thinking.The false positive rate of atropinization, the cases of patients with the occurrence of intermediate syndrome and the average hospitalization were compared between two groups .Results The false positive rate of atropinization in the control group was 30.0%, and was 10.0% in the observation group, and the difference was statistically significant （χ2 =7.50,P〈0.01）.The cases of patients with the occurrence of intermediate syndrome in the control group was 13 cases（21.7%）, and was 5 cases（8.3%） in the observation group, and the difference was statistically significant （χ2 =4.18,P〈0.05）.The average hospitalization was （11.25 ±2.14） d in the observation group, and was lower than that in the control group , and the difference was statistically significant （t=0.120 9,P〈0.05）.Conclusions Application of critical thinking in the observation of atropinization can reduce the false positive rate of atropinization , and decrease the incidence of complications , and shorten the length of hospital stay , and relieve the burden on patients .