图例讲解法沟通方式对行经皮冠状动脉介入治疗的急性心肌梗死患者抢救效果的影响

Impact of Flowchart-based Pre-treatment Communication Between Well-trained Nurses and Patient Family Members on Rescue Effect in Acute Myocardial Infarction Patients Undergoing Percutaneous Coronary Intervention

目的探讨图例讲解法沟通方式对行经皮冠状动脉介入治疗(PCI)的急性心肌梗死患者抢救效果的影响。方法选取2016年1月—2018年2月在徐州医科大学附属淮安医院拟行PCI的急性心肌梗死患者90例,采用随机数字表法分为对照组和研究组,每组45例。两组患者入院后立即启动绿色通道,对照组患者家属予以临床常规沟通方式,研究组患者家属予以图例讲解法沟通方式。比较两组患者家属犹豫情况(包括犹豫人数、犹豫时间)及患者"门球"时间(D-to-B时间),住院期间病死率,住院时间,术前及出院前1 d左心室射血分数(LVEF),出院前1 d 6分钟步行距离(6MWD)。结果 (1)研究组患者家属犹豫者所占比例低于对照组,家属犹豫时间及患者D-to-B时间短于对照组(P<0.05)。(2)两组患者住院期间病死率比较,差异无统计学意义(P>0.05)。(3)研究组患者住院时间短于对照组(P<0.05)。两组患者术前LVEF比较,差异无统计学意义(P>0.05);研究组患者出院前1 d LVEF高于对照组,6MWD长于对照组(P<0.05)。结论图例讲解法沟通方式能有效缩短行PCI的急性心肌梗死患者家属犹豫时间,进而缩短患者D-to-B时间及住院时间,促进患者心功能恢复。

Objective To investigate the impact of flowchart-based pre-treatment communication between well-trained nurse and patient family members on rescue effect in acute myocardial infarction(AMI)patients undergoing percutaneous coronary intervention(PCI).Methods From January 2016 to February 2018,90 AMI patients underwent PCI were selected in Huaian Hospital Affiliated to Xuzhou Medical University,and they were divided into control group and study group by using random number table method,with 45 cases in each gruop.Patients in the two group were given care via Emergency Green Channel immediately after admission,thereinto patient family members in control group received routine clinical communication mode,while patient family members in study group received flowchart-based pre-treatment communication mode.Proportion and hesitation time of patient family members with hesitation,door-to-balloon(D-to-B)time,fatality rate during hospitalization,hospital stays,LVEF before operation and 1 day before discharge,and 6-minute walking distance 1 day before discharge were compared between the two groups.Results(1)Proportion of patient family members with hesitation in study group was statistically significantly lower than that in control group,meanwhile hesitation time of patient family members and D-to-B time in study group were statistically significantly shorter than those in control group(P<0.05).(2)There was no statistically significant difference in fatality rate between the two groups during hospitalization (P>0.05).(3)Hospital stays in study group was statistically significantly shorter than that in control group(P<0.05).No statistically significant difference of LVEF was found between the two groups before operation(P>0.05);1 day beforedischarge,LVEF in study group was statistically significantly higher than that in control group,meanwhile 6-minute walkingdistance in study group was statistically significantly longer than that in control group 1 day before discharge(P<0.05).Conclusion Flowchart-based pre-treatment communication between well-trained nurse and patient family members caneffectively shorten hesitation time of patient family members,whereupon D-to-B time may be shortened,and promote thepatients' recovery of cardiac function.