16例体外膜肺氧合急救患者的集束化管理策略探讨

Cluster Management Strategy of 16 Emergency Patients with Extracorporeal Membrane Oxygenation

目的:探讨集束化管理策略在危重症患者应用体外膜肺氧合(ECMO)救治中的应用效果。方法:选取2020年1月-2021年4月在东莞市人民医院实施膜肺氧合救治的16例危重症患者的临床资料,在ECMO治疗过程中均采用ECMO集束化管理策略,包括制定专用的ECMO急救车、建立快速反应护理单元、对所需物品制定表格清单管理及建立ECMO标准化的培训方案,观察记录其护理人员到位时间、物品准备时间、管道预冲时间、上机总耗时、患者脱概率和生有率。结果:实施集束化管理策略后,ECMO救治团队的护理人员到位时间、物品准备时间、管道预充时间显著缩短,且无备物错漏事件发生。16例患者总脱概率75.00%,总生存率68.75%。结论:集束化管理策略能够规范ECMO的标准化操作流程,利于提高救治效率和成功率,保证治疗顺利进行。

Objective:To explore the application effect of cluster management strategy in the treatment of critically ill patients with extracorporeal membrane oxygenation(ECMO).Methods:The clinical data of 16 critically ill patients treated by membrane oxygenation in Dongguan People's Hospital from January 2020 to April 2021 were selected.In the course of ECMO treatment,ECMO cluster management strategy was adopted,including the development of special ECMO emergency vehicle,the establishment of rapid response nursing unit,the list management of required items and the establishment of standardized ECMO training program.The arrival time of nursing staff,the preparation time of supplies,the prefilling time of pipelines,total duration of ECMO,rate of removal and rate of survival were observed and recorded.Results:After the implementation of the cluster management strategy,the arrival time of nursing staff,the preparation time of supplies,and the prefilling time of pipelines in the ECMO treatment team were significantly shortened,and there were no incidents of faulty supplies.The overall removal rate of 16 patients was 75.00%and the overall survival rate was 68.75%.Conclusion:Cluster management strategy can standardize the standardized operation process of ECMO,which is conducive to improve the efficiency and success rate of treatment and ensure the smooth progress of treatment.