基于循证的急诊护理流程在急性缺血性脑卒中患者中的应用

Application of evidence-based emergency nursing process in patients with acute ischemic stroke

目的研究基于循证的急诊护理流程在急性缺血性脑卒中患者中的应用效果。方法选取2021年3月至2022年2月在惠州市中医医院治疗的68例急性缺血性脑卒中患者进行研究。按照实施时间不同分为对照组(2021年3~8月)和研究组(2021年9月至2022年2月)各34例。对照组采用常规的急诊护理,研究组采用基于循证的急诊护理流程。护理14 d后比较两组患者的静脉开通时间、CT检查时间及患者就诊至静脉溶栓用药时间(DNT),对比护理前后两组患者的神经功能缺损评分[参照神经功能缺损量表(NIHSS)]、认知功能评分[参照简易精神状态量表(MMSE)]、日常生活能力评分[参照日常生活能力量表(ADL)]以及护理后并发症发生率、溶栓成功率,并评估两组患者的护理总有效率。结果研究组患者的静脉开通时间、CT检查时间及DNT分别为(9.25±1.56)min、(25.31±4.02)min、(54.23±6.44)min,明显短于对照组的(9.25±1.56)min、(25.31±4.02)min、(54.23±6.44)min,差异均有统计学意义(P<0.05);护理前,两组患者的NIHSS、MMSE、ADL评分比较差异均无统计学意义(P>0.05);护理后,研究组患者的NIHSS评分为(14.42±3.68)分,较护理前降低,且明显低于对照组的(21.32±3.72)分,差异均有统计学意义(P<0.05);护理后,研究组患者的MMSE、ADL评分分别为(29.47±7.59)分、(80.18±5.11)分,均较护理前升高,且明显高于对照组的(24.84±6.76)分、(75.91±4.41)分,差异均有统计学意义(P<0.05);研究组患者的并发症发生率为11.76%,明显低于对照组的35.29%,差异有统计学意义(P<0.05);研究组患者的溶栓成功率、护理总有效率分别为94.12%、97.06%,明显高于对照组的70.59%、73.53%,差异均有统计学意义(P<0.05)。结论基于循证的急诊护理流程应用于急性缺血性脑卒中,能明显改善患者的神经缺损情况,护理效果好,具有临床推广价值。

Objective To study the application effect of evidence-based emergency nursing process in patients with acute ischemic stroke.Methods Sixty-eight patients with acute ischemic stroke treated in Huizhou Hospital of Traditional Chinese Medicine from Mar.2021 to Feb.2022 were selected for the study.According to the different time period,they were divided into the control group and the study group,with 34 cases in each group.The control group(from Mar.2021 to Aug.2021)used routine emergency nursing,and the study group(from Sep.2021 to Feb.2022)applied evidence-based emergency nursing process.After 14 days of nursing,the venous opening time,CT examination time,and the time from the patient's visit to the intravenous thrombolytic medication(DNT)were compared between the two groups.The neurological function defect score[refer to the neurological function defect scale(NIHSS)],cognitive function score[refer to the simplified mental State Scale(MMSE)],the ability of daily living score[refer to the ability of daily living scale(ADL)],and the complication rate after nursing were compared between the two groups,as well as the success rate of thrombolysis.The total effective rate of nursing care in the two groups was evaluated.Results The venous patency time,CT examination time,and DNT of patients in the study group were(9.25±1.56)min,(25.31±4.02)min,(54.23±6.44)min,which were significantly shorter than(9.25±1.56)min,(25.31±4.02)min,(54.23±6.44)min in the control group(P<0.05).Before nursing,there was no significant difference in NIHSS,MMSE,and ADL scores between the two groups(P>0.05);after nursing,the NIHSS score of the patients in the study group was(14.42±3.68)points,which was significantly lower than that before nursing and significantly lower than(21.32±3.72)points in the control group(P<0.05).After nursing,the MMSE and ADL scores of the patients in the study group were(29.47±7.59)points and(80.18±5.11)points,respectively,which were significantly higher than those before nursing and significantly higher than(24.84±6.76)points and(75.91±4.41)points of the control group(P<0.05).The complication rate of the study group was 11.76%,which was significantly lower than 35.29%of the control group(P<0.05).The successful rate of thrombolysis and the total effective rate of nursing in the study group were 94.12%and 97.06%,respectively,which were significantly higher than 70.59%and 73.53%in the control group(P<0.05).Conclusion The application of evidence-based emergency nursing process in acute ischemic stroke can significantly improve the neurological defect of patients,with good nursing effect,which is worth promoting.