脑缺血患者急性期心律失常监测临床研究

Clinical study on arrhythmia monitoring in patients with the acute cerebral ischemia

目的探讨缺血性脑血管病(ischemic cerebrovascular disease,ICVD)患者24 h内心律失常的发生率以及护士对心律失常的识别率,为临床诊断、治疗提供依据。方法纳入120例ICVD患者作为观察组,同期住院非脑血管病患者60例作为对照组。参与项目的护士分为2组,其中A组护士经过心律失常知识培训3 d,B组护士未经过培训,事先未被告知。2组护士安排为同一个班次,同时记录观察组与对照组发病后24 h内心律失常的发生率与发生类型。结果观察组心律失常的发生率为74.1%(89/120),对照组为15.0%(9/60),观察组明显高于对照组(P<0.01);ICVD患者急性期心律失常最常见类型为房颤(40.9%),其次为心动过缓(23.3%)、心动过速(9.1%);A组护士对纳入180例患者24 h内心律失常的识别率为98.0%(96/98),B组护士为82.6%(81/98),两者比较有显著差异(P<0.01)。结论ICVD患者急性期心律失常发生率高,应予以重视;ICVD患者24 h内发生心律失常的类型以房颤多见;经过培训的护士在识别心律失常方面更为敏感,应加强神经内科护士心律失常相关知识的培训,以提高心律失常的识别率,改善患者预后。

Objective To investigatethe incidence of arrhythmia in patients with ischemic cerebrovascular disease(ICVD)within 24 hours and the recognition rate of arrhythmia by nurses,and to provide evidence for clinical diagnosis and treatment.Methods 120 patients with ICVD were enrolled in the observation group,and 60 patients with non-cerebral vascular disease were enrolled in the same period as the control group.The nurses participating in the project were divided into two groups.Among them,the nurses in group A were trained in arrhythmia knowledge for 3 days.The nurses in group B were not trained and were not informed beforehand.The two groups of nurses were arranged for the same shift,and the incidence and types of arrhythmia within 24 hours after the onset of the observation group and the control group were recorded.Results The incidence of arrhythmia in the observation group was 74.1%(89/120),and that in the control group was 15.0%(9/60).The observation group was significantly higher than the control group(P<0.01).The most common type of acute arrhythmia in ICVD patients for atrial fibrillation(40.9%),followed by bradycardia(23.3%),tachycardia(9.1%).The recognition rate of nurses in group A and group B for arrhythmias was 98.0%(96/98)and 82.6%(81/98),and there was a significant difference between the two groups(P<0.01).Conclusion The incidence of arrhythmia in patients of acute phase with ICVD is higher,and should be paid attention.The type of arrhythmia occurring in ICVD patients is more common in atrial fibrillation within 24 hours.The trained nurses are more sensitive in identifying arrhythmia,in order to improve the rate of arrhythmia identification and prognosis of patients,the training on arrhythmia knowledge of neurology nurses should be strengthened.