急诊快捷护理流程在急性心肌梗死患者急救中的应用

EMERGENCY QUICK APPLICATION OF NURSING PROCESS IN EMERGENCY TREATMENT OF PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

目的为降低急诊心肌梗死(acute myocardial infarction,AMI)病死率,改善患者预后,试建立急诊快捷护理流程,总结经验。方法 2014年全年,医院收治AMI患者203例为常规组,给予常规护理,诊断AMI启动绿色通道,2015年全年收治AMI患者205例为观察组,工作小组深入分析了医院AMI急诊急救护理流程,制定落实快捷评价病情、快捷救护、快捷交接等一系列的急诊快捷护理措施,改进AMI急救护理流程。结果观察组早期灌注率45.4%、总灌注率63.9%高于常规组34.0%、55.4%,观察组发病到确诊AMI、发病到溶栓治疗、急诊至球囊扩张时间分别为(6.7±2.2)h、(5.1±1.5)h、(75.4±10.4)min低于常规组(7.5±2.4)h、(5.8±1.4)h、(88.3±12.1)min,观察组死亡率、并发症合计率26.8%、出院后6个月心血管事件发生率5.9%低于常规组6.9%、39.9%、11.3%,差异具有统计学意义(P<0.05)。结论新的AMI急诊快捷护理流程确实有助于提高救护效率,改善患者预后。

Objective To reduce the mortality rate of acute myocardial infarction, and improve the prognosis of patients, and trying to establish emergency and quick care processes, and lessons learned. Methods In 2014,203 cases of AMI patients admitted to hospital were selected for the control group,who received routine care and started the green channel for being diagnosed AMI; in 2015,all 205 cases of patients with AMI were as the observation group.AMI Working Group analyzed hospital emergency care processes,implement a quick evaluation of the condition,fast ambulance, rapid succession a series of shortcut in emergency nursing,impro ving AMI emergency care procedures.Results The early perfusion rate and total perfusion rate were45.4%, and 63.9% in observation group,which higher than general group with 34% and 55.4%.In observation group, the time from onset to confirmed AMI,onset to dissolved tied treatment,and emergency to ball SAC expan- sion were （6.7 ± 2.21 h,（5.1 ± 1.51 h and （75.4 ± 10.4} rain respectively,they were below than control group with （7.5± 2.4} h,（5.8 ± 1.4） h,and （88.3 ± 12.1） rain.Total mortality,complication rates in the observation group 26.8% ,6 months after discharge from hospital cardiovascular event rate was 5.9%, lower than the control group with 6.9%, 39.9%, 11.3%, the difference was statistically significant [ P 〈0.05）.Con- clusion The new AMI shortcut in emergency nursing process does improve the efficiency of ambulance,ira proves the patient＇s prognosis.