分级分区护理管理对急性心肌梗死患者急救效果及心功能的影响

Effects of grading and zoning nursing management on first aid and cardiac function among patients with acute myocardial infarction

目的 探讨分级分区护理管理对急性心肌梗死患者急救效果及心功能的影响.方法 以2015年2月—2019年1月海安市人民医院收治的300例急性心肌梗死患者为研究对象,根据患者护理方式分为对照组153例(2015年2月—2017年3月)与试验组147例(2017年4月—2019年1月).对照组采用常规急诊护理模式,试验组采用分级分区护理管理.对比两组患者的急救相关时间指标、住院时间、住院费用、梗死相关血管再通率、存活率及存活患者心功能.结果 试验组分诊时间、急诊心电图时间、急诊经皮冠状动脉内介入术(PCI)治疗时间较对照组缩短(P<0.05).试验组患者住院时间、住院费用均低于对照组(P<0.05).试验组患者的梗死相关血管再通率、存活率高对照组(P<0.05).治疗后6个月,两组左心室舒张末期内径(LVEDD)、左心室舒张收缩末期内径(LVESD)水平低于治疗前,且试验组低于对照组(P<0.05);两组左心室射血分数(LVEF)水平高于治疗前,且且试验组高于对照组(P<0.05).结论 分级分区护理管理对急性心肌梗死患者急救效果较好,可有效提高急救速度,改善患者预后及心功能,进而减轻其医疗负担.

Objective To explore the ffects of grading and zoning nursing management on first aid and cardiac func-tion among patients with acute myocardial infaretion(AMI).Methods 300 demographically matched patients with AMI were divided into 2 groups according to the nursing mode:control group(admitted before March 2017 and treated with routine emergeney nursing mode,n=153)and experimental group(admitted from April 2017 to January 2019,treated with grading and zoning nursing management,n=147).The first aid-related time index,hospitalization time,hospitaliza-tion cost,infarction-related vascular recanalization rate,survival rate and cardiac function of surviving patients were compared between the two groups.Results The consultation time,emergency electrocardiogram time,and percutaneous coronary intervention(PCI)trealment time in the experimental group were all significanly shorter than those in the con-trol group(all P<0.05).The hospitalization time and cost of the patients in the experimental group were both significant-ly lower than those in the control group(both P<0.05).The recanalization rate and survival rate of infarction-related vessels in the experimental group were both higher than those in the control group(both P<0.05).6 months after treat-ment,the levels of left ventricular end-diastolic diameter(LVEDD)and left ventricular end-diastolie diameter(LV ESD)in the lwo groups both decreased,and those in the experimental group were both significantly lower than those in the control group(both P<0.05),and the levels of left ventricular ection fraction(LVEF)in the two groups both in-creased,and the LV EF level in the experimental group was significantly higher than that in the control group(P<0.05).Conclusion Improving the first-aid speed,patients’prognosis and heart function,and further reducing the medical burden,grading and zoning nursing management is effective in first-aid for the AMI patients.