MEWS指导下的一体化急救护理对AMI患者的影响

Influence of Integrated Emergency Care under the Guidance of Modified Early Warning Score(MEWS)on AMI Patients

目的:探讨改良早期预警评分(MEWS)指导下的一体化急救护理对急性心肌梗死(AMI)患者的影响。方法:选取2017年10月1日~2019年10月1日收治的122例AMI患者,按照1∶1配对随机分为对照组和观察组各61例。对照组实施常规护理,观察组在常规护理基础上实施MEWS指导下的一体化急救护理。比较两组抢救成功率、院前急救反应时间、分诊评估时间、首次心电图采集时间、抢救时间、并发症、院前急救护理工作满意度[采用服务质量量表(SERVQUAL)],比较两组护理前后正性心理[采用创伤后成长量表(PTGI)]、心脏功能[包括左心射血分数(LVEF)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)]、生活质量[采用健康调查简表(SF-36)]。结果:观察组院前急救反应时间、分诊评估时间、首次心电图采集时间、抢救时间短于对照组(P<0.01),抢救成功率高于对照组(P<0.01),并发症发生率低于对照组(P<0.01);护理后,两组PTGI中新的可能性、与他人关系、精神改变、个人力量及欣赏生活维度得分高于护理前(P<0.05),且观察组高于对照组(P<0.01);护理后,两组LAEF、LVESD、LVEDD优于护理前(P<0.05),且观察组优于对照组(P<0.01);护理后,两组SF-36中身体疼痛、生理功能、情感智能及社会功能维度得分高于护理前(P<0.05),且观察组高于对照组(P<0.01);观察组SERVQUAL中反应性、移情性、可靠性、有形性、保证性得分高于对照组(P<0.01)。结论:MEWS指导下的一体化急救护理能提高医护人员急救工作效率,缩短AMI患者抢救时间,提升抢救成功率,可改善患者心功能,降低并发症风险,减轻心理应激,改善生活质量,提高护理满意度。

Objective:To investigate the effect of integrated emergency care under the guidance of MEWS on patients with acute myocardial infarction(AMI).Methods:A total of 122 patients with AMI admitted from October 1,2017 to October 1,2019 were selected and randomly divided into control group and observation group with 61 patients each according to 1:1 pairing.The control group received routine nursing,while the observation group received integrated emergency care under the guidance of MEWS on the basis of routine nursing.The rescue success rate,reaction time,triage assessment time,ECG acquisition time for the first time,rescue time,complications and pre-hospital emergency nursing job satisfaction[using service quality scale(SERVQUAL)]were compared between the two groups.The positive psychology[the posttraumatic growth Inventory(PTGI)],heart function[including left ventricular ejection fraction(LVEF),left ventricular end systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD)],and the quality of life[by the MOS item short from health survey(SF-36)]were compared before and after nursing between the two groups.Results:The first aid response time,triage evaluation time,the first ECG collection time and rescue time in the observation group were shorter than those in the control group(P<0.01),the rescue success rate was higher than that in the control group(P<0.01),and the complication rate was lower than that in the control group(P<0.01).After nursing,the score of PTGI in new possibility,relationship with others,spiritual change,personal strength and life appreciation dimension was higher in the two groups than before nursing(P<0.05),and the observation group was higher than the control group(P<0.01).After nursing,LAEF,LVESD and LVEDD in the two groups were better than before nursing(P<0.05),and the observation group was better than the control group(P<0.01).After nursing,the scores of SF-36 in physical pain,physiological function,emotional intelligence and social function dimension in the two groups were higher than those before nursing(P<0.05),and the observation group was higher than the control group(P<0.01).The scores of SERVQUAL in reactivity,empathy,reliability,tangibility and assurance in the observation group were higher than those in the control group(P<0.01).Conclusion:Integrated emergency care under the guidance of MEWS can promote the emergency work efficiency of medical staff,shorten the rescue time of AMI patients,improve the success rate of rescue,improve patients′cardiac function,reduce the risk of complications,reduce psychological stress,improve the quality of life,and promote nursing satisfaction.