同质化管理对急性脑梗死静脉溶栓治疗中目标血压控制效果研究

The Effect of Homogenization Management on Target Blood Pressure Control in Intravenous Thrombolysis for Acute Cerebral Infarction

目的探索急性脑梗死患者行静脉溶栓治疗前后同质化管理对目标血压控制的临床效果。方法选取神经内科63例实施阿替普酶静脉溶栓的急性脑梗死患者作为研究对象。按照数字随机表法,选取其中30例作为对照组,另外33例作为观察组。对照组接受溶栓治疗常规护理,观察组在常规护理基础上,实施同质化护理工作指引的管理,采取针对性的护理干预控制血压。对比两组患者目标血压的控制效果、症状改善及并发症的发生和预后。结果两组患者溶栓前血压高于目标血压者比较,差异无统计学意义(P>0.05);溶栓后,经过护理干预,观察组血压控制在目标范围内例数高于对照组;观察组患者溶栓治疗后症状改善率(NIHSS)高于对照组;观察组同质化干预后术后死亡率及出血率低于对照组;差异均有统计学意义(P<0.05)。结论实施同质化的目标血压管理,通过针对性的护理干预,达到静脉溶栓前后目标血压的有效控制,从而保证溶栓的顺利进行及减少溶栓后严重并发症的发生,保证患者的良好预后。

Objective To explore the clinical effect of homogenization management on target blood pressure control before and after intravenous thrombolysis in patients with acute cerebral infarction. Methods 63 patients with acute cerebral infarction who received intravenous thrombolysis with intravenous thrombolytic therapy were selected. According to the digital random table method, 30 cases were selected as the control group and the other 33 cases as the observation group. The control group was treated with thrombolytic therapy for routine nursing care. On the basis of routine nursing care, the observation group implemented the management of homogeneity nursing work guidelines, and adopted targeted nursing intervention to control blood pressure. The control effect, improvement of symptoms, complications and prognosis of the two groups were compared. Results There was no significant difference in blood pressure between the two groups before thrombolytic therapy was higher than that of target blood pressure（P〈0.05）. After thrombolysis, after nursing intervention, the blood pressure control in the observation group was significantly higher than that in the control group. The improvement rate of symptoms in the observation group after thrombolytic therapy（NIHSS） was higher than that in the control group. The mortality and bleeding rate of the observation group were lower than those of the control group（P〈0.05）. ConclusionImplementation of homogenized target blood pressure management, through targeted nursing interventions, to achieve effective control of target blood pressure before and after intravenous thrombolysis, so as to ensure the smooth progress of thrombolysis and reduce the occurrence of severe complications after thrombolysis, ensure the patient＇s good prognosis.