多学科合作模式联合结构化护理在行体外膜肺氧合辅助治疗心肺衰竭患者中的应用研究

Application of Multidisciplinary Model Combined with Structured Care in Patients with Cardiopulmonary Failure Treated with Extracorporeal Membrane Oxygenation

目的:探讨多学科合作(multidisciplinary team,MDT)模式联合结构化护理在行体外膜肺氧合(extracorporeal membrane oxygenation,ECMO)辅助治疗的心肺衰竭患者中的应用效果。方法:选取2018年1月-2021年6月驻马店市中心医院收治的56例行ECMO辅助治疗的严重心肺衰竭患者作为研究对象,按照随机数表法分为对照组和观察组,每组各28例。对照组采用常规护理,观察组在常规护理基础上实施MDT模式联合结构化护理干预。比较两组患者抢救效率(物资准备时间、管路预充时间、ECMO置管时间、ECMO建立时间)、并发症发生率及死亡率。结果:观察组物资准备时间、管路预充时间、ECMO置管时间、ECMO建立时间均明显短于对照组,差异有统计学意义(t=33.555、26.032、20.133、30.434,P<0.05)。观察组并发症发生率为10.71%,明显低于对照组的39.29%,差异有统计学意义(χ^(2)=6.095,P<0.05)。观察组死亡率为42.86%,明显低于对照组的71.43%,差异有统计学意义(χ^(2)=4.667,P<0.05)。结论:MDT模式联合结构化护理干预,能够有效提高行ECMO辅助治疗严重心肺衰竭患者的抢救效率,减少并发症发生率,降低死亡率,改善患者预后。

Objective:To investigate the effectiveness of multidisciplinary team(MDT)model combined with structured care in patients with heart and lung failure treated with extracorporeal membrane oxygenation(ECMO)assisted therapy.Methods:56 patients with severe cardiopulmonary failure admitted to the hospital for ECMO-assisted treatment from January 2018 to June 2021 were selected as study subjects and divided into control group and observation group according to the random number table method,with 28 cases in each group.The control group used conventional care,and the observation group implemented MDT model combined with structured care intervention on the basis of conventional care.The resuscitation efficiency(material preparation time,line pre-filling time,ECMO placement time,ECMO establishment time),complication rate and mortality rate of patients in the two groups were compared.Results:The material preparation time,line pre-filling time,ECMO placement time,and ECMO establishment time were significantly shorter in the observation group than in the control group,with statistically significant differences(t=33.555,26.032,20.133,30.434,P<0.05).The complication rate in the observation group was 10.71%,which was significantly lower than 39.29%in the control group,and the difference was statistically significant(χ^(2)=6.095,P<0.05).The mortality rate in the observation group was 42.86%,which was significantly lower than 71.43%in the control group,and the difference was statistically significant(χ^(2)=4.667,P<0.05).Conclusion:The MDT model combined with structured nursing interventions can effectively improve the resuscitation efficiency,reduce the complication rate,decrease the mortality rate and improve the prognosis of patients undergoing ECMO-assisted treatment for severe heart and lung failure.