医护合作干预主动脉夹层继发精神症状患者的效果

Effects of healthcare cooperative intervention on patients with psychiatric symptoms secondary to aortic dissection

目的主动脉夹层起病急、病情变化快,易诱发精神症状,影响患者的生命安全,文中采取医护合作干预方法研究对主动脉夹层患者继发精神症状的救治效果。方法构建医护合作组织架构;制定快速评估表和＂一看二问三查四判五报＂流程,建立快速救治绿色通道。选择32例主动脉夹层继发精神症状患者采用上述方法进行干预,观察确诊时间、从确诊到实施手术的时间,精神症状缓解时间、不良事件发生情况和住院时间。结果本组32例患者均在就诊后30 min内明确诊断,在确诊后30 min内紧急实施手术,较以往确诊和实施手术准备时间缩短1-2 h。手术后5-21 d精神症状均得到有效控制,未发生拔管、坠床、自伤或伤人等不良事件,无一例死亡,平均住院时间13.5 d,比以往同类患者住院时间缩短1.75 d。结论医护合作干预方法能快速识别主动脉夹层继发精神症状的患者、有效干预,避免不良事件,缩短住院时间。

Objective Aortic dissection is accute in occurrence along with fast change,which is inclined to to induce psychotic symptoms and affect the lives of patients. The study was to investigate the effects of healthcare cooperative intervention on patients with psychiatric symptoms secondary to aortic dissection. Methods We established medical cooperation organization structure to clarify the division of responsibility along with a quick assessment form,a process chart and a green channel for emergencey treatment. The above method was applied to intervene 32 patients with psychiatric symptoms secondary to aortic dissection and observe the diagnosis time,the time from diagnosis to surgery,the remission time of psychiatric symptoms,the incidence of adverse events and the length of stay. Results 32 patients were diagnosed within 30 min followed by emergency surgery within 30 min after diagnosis,which was 1- 2 hours shorter than the previous diagnosis and surgery preparation time. 5- 21 d after surgery,psychiatric symptoms have been effectively controlled. Extubation,falling out of bed,self-injury or injury and other adverse events did not occur. No patient died,and the average length of stay was 13. 5d,which was 1. 75 d shorter than the length of stay of previous similar patients. Conclusion The healthcare cooperation method can quickly identify patients with psychiatric symptoms secondary to aortic dissection,prevent adverse events and shorten the length of stay.