优化急诊护理流程对急性脑梗死患者急救效果的研究

Study on the effect of optimizing emergency nursing procedure on emergency treatment of patients with acute cerebral infarction

目的探讨优化急诊护理流程对急性脑梗死(acute cerebral infarction,ACI)患者神经功能缺损和日常生活能力的影响。方法选取2017年1月—2018年6月在绍兴市人民医院进行诊治的88例ACI患者为研究对象,采用随机数字表法将其分为观察组和对照组,各44例,对照组以常规急诊护理流程进行护理,观察组以优化急诊护理流程进行护理,记录比较2组患者在急救过程中的医生到位时间、到院至CT检查时间、到院至CT报告时间和到院至静脉溶栓时间(DTN),溶栓前和溶栓24 h后的美国国立卫生研究院卒中量表(NIHSS)评分和Barthel指数(BI),以及2组患者的急救成功率、死亡率和致残率。结果观察组医生到位时间、到院至CT检查时间、到院至CT报告时间和DTN均显著短于对照组(均P<0.05);溶栓前,2组的NIHSS评分和BI差异无统计学意义(均P>0.05),溶栓24 h后观察组的NIHSS评分显著低于对照组(P<0.05),BI显著高于对照组(P<0.05);观察组的急救成功率为81.82%,显著高于对照组的59.09%(P<0.05),而2组的死亡率和致残率差异无统计学意义(均P>0.05)。结论优化急诊护理流程能够缩短对ACI患者的急救时间,提高急救成功率,并改善患者的神经功能缺损情况和日常生活能力。

Objective To explore the effect of optimizing emergency nursing process on neurological deficit and daily living ability in patients with acute cerebral infarction(ACI). Methods Totally 88 patients with ACI who were diagnosed and treated in Shaoxing people’s hospital from January 2017 to June 2018 were selected and divided into observation group and control group with 44 cases in each group. The control group was treated with routine emergency nursing procedure, and the observation group was treated with optimizing emergency nursing process. Record and compare the times of doctor arrival, door to CT examination, door to CT report and door to needle(DTN) between the two groups. Compare the National Institutes of Health Stroke scale(NIHSS) score and Barthel index(BI) before and 24 hours after thrombolytic therapy between the two groups. Compare the first aid success rate, mortality rate and disability rate between the two groups. Results The times of doctor arrival, door to CT examination, door to CT report and DTN in the observation group were significantly shorter than those in the control group(all P<0.05). Before thrombolytic therapy, there was no significant difference in NIHSS score and BI between the two groups(all P>0.05). The NIHSS score of the observation group was significantly lower than that of the control group 24 hours after thrombolysis(P<0.05), and the BI of the observation group was significantly higher than that of the control group 24 hours after thrombolysis(P<0.05). The success rate of first aid in the observation group was 81.82%,which was significantly higher than 59.09% in the control group(P<0.05), but there was no significant difference in mortality rate and disability rate between the two groups(all P>0.05). Conclusion The optimization emergency nursing process can shorten the time of first aid to ACI patients, improve the success rate of emergency treatment, and improve the neurological deficit and daily living ability of patients.