应用院前急救评价方法抢救106例脑卒中患者的急救体会

Application of Pre-hospital Emergency Rescue of 106 Cases of Emergency Evaluation of Stroke Patients Experience

目的探讨应用院前急救评价方法抢救106例脑卒中患者的接诊流程与护理急救措施的效果,以提升危重脑卒中的急诊急救水平。方法回顾性分析急救中心2009年6月至2013年6月急诊科106例脑血管意外患者的急救资料。分为实验组58例,对照组48例。实验组采用急救诊断主要根据9项评估指标(体格检查、脉搏、血压、呼吸频率、血氧饱和度、体温、意识状态、心电图检查、血糖测定)以及患者病史、临床症状、体征并联合格拉斯哥昏迷(GCS)评分做出。对照组急救诊断主要依据病史、症状、体征做出。统计出现场确诊的例数、现场救治成功以及临床死亡例数;患者转运成功及转运成功后死亡的例数;急救重症科后续抢救成功及其死亡的例数。结果实验组现场明确诊断54例(占93.1%),对照组现场明确诊断28例(占58.3%),两组比较差异有统计学意义(P<0.05)。实验组现场急救成功率、转运成功率、急诊科延续抢救成功率均明显高于对照组,差异有统计学意义(P<0.05)。结论实验组在发病现场就有了明确的急救诊断,尽快进入了标准化治疗过程,及时有效地把患者转运到就近医院并在急诊科得到安全的后续治疗,及时准确地护送到ICU或专科重症病房,极大地减少了患者的病死率,可能会提高早期救治率。

Objective To study the application of evaluation method of the rescue of 106 cases of cerebral apoplexy patients accepts processes and the effect of emergency nursing measures, to enhance the level of critical stroke of emergency ifrst aid.Methods Retrospective analysis from June 2009 to June 2013 emergency department emergency data of 106 patients with cerebrovascular accident. Divided into the experimental group, 58 cases, control group of 48 cases. Group emergency diagnosis mainly based on eight evaluation index（blood pressure, pulse, respiration, body temperature, blood oxygen saturation, consciousness, electrocardiogram, blood sugar）and medical history, symptoms, signs and Glasgow coma score（GCS）. Control emergency diagnosis is mainly based on medical history, symptoms and signs. Statistical diagnosis cases, on-site ifrst-aid success and the number of cases of death; Transfer success and the number of cases of death; The emergency department and death cases of successful rescue.Results The experimental site diagnosis 54 cases（93.1%）and control group in the diagnosis of 28 cases （58.3%）, is similar between the two groups was statistically signiifcant（P〈0.05）. Experimental group on-site ifrst-aid success rate of the success rate, transshipment, emergency department continued rescue success rate were signiifcantly higher than that of control group, the difference was statistically signiifcant（P〈0.05）.Conclusion The experimental group in the ifeld has been clear about the emergency diagnosis as soon as possible, as soon as possible into the standardized treatment, timely and safe transfer the patient to the hospital and get effective follow-up treatment in the emergency department, security escort or junior to the ICU ward, greatly reduce the case fatality rate of patients, may increase the rate of early treatment.