摘要
目的:探讨优化院前急诊护理及医疗处理流程在急性脑梗死患者发病后的应用效果及影响因素。方法:回顾性分析2016年2月1日~2018年8月31日收治的84例急性脑梗死患者资料,将患者按照急诊护理流程的差异分为干预组和对照组各42例。对照组给予常规急诊护理流程干预,干预组遵从优化院前急诊护理流程实施护理。比较两组院前延迟时间、预后情况、治疗前后神经功能缺损情况[采用美国国立卫生研究院卒中量表(NIHSS)]及满意度,并通过Logistic回归分析急性脑梗死患者康复的影响因素。结果:干预组院前延迟时间<2 h的人数占比高于对照组(P<0.05),而院前延迟时间>5 h的人数占比低于对照组(P<0.05);干预组病情稳定出院率、转入专科治疗率高于对照组(P<0.05),48 h内病死率低于对照组(P<0.05);治疗前,两组NIHSS评分比较差异无统计学意义(P>0.05);治疗后2、4 d,干预组NIHSS评分低于对照组(P<0.05);干预组满意度高于对照组(P<0.05);根据Logistic回归分析法评价可知,患者康复的影响因素为年龄、未使用优化院前急诊护理流程护理及意识障碍(P<0.05)。结论:优化院前急诊护理及医疗处理流程可显著缩短急性脑梗死患者发病后院前延迟时间,改善患者预后,促进患者神经功能缺损恢复,提高满意度。
Objective:To explore the application effect and influencing factors of optimizing pre-hospital emergency care and medical treatment process in patients with acute cerebral infarction after the onset of the disease.Methods:The data of 84 patients with acute cerebral infarction admitted from February 1,2016 to August 31,2018 were retrospectively analyzed,and the patients were divided into the intervention group and the control group according to the differences in emergency care procedures.The control group was given routine emergency nursing process intervention,and the intervention group was implemented the nursing followed the optimization of pre-hospital emergency nursing process.Prehospital delay,prognosis,neurological deficits[using the national institutes of health stroke scale(NIHSS)]before and after treatment and satisfaction were compared between the two groups,and Logistic regression was used to analyze the influencing factors of recovery in patients with acute cerebral infarction.Results:The proportion of patients with pre-hospital delay time<2 hours in the intervention group was higher than that in the control group(P<0.05),while the proportion of patients with pre-hospital delay time>5 hours was lower than that in the control group(P<0.05).The stable discharge rate and the rate of transferring to specialized treatment in the intervention group were higher than that in the control group(P<0.05),and the case fatality rate within 48 hours was lower than that in the control group(P<0.05).Before treatment,there was no statistically significant difference in NIHSS scores between the two groups(P>0.05).NIHSS score in the intervention group was lower than that in the control group 2 and 4 days after treatment(P<0.05).The satisfaction of the intervention group was higher than that of the control group(P<0.05).According to the Logistic regression analysis,the influencing factors of the patient′s recovery were age,the nursing without the optimized pre-hospital emergency care,and the consciousness disorder(P<0.05).Conclusion:Optimizing the pre-hospital emergency care and medical treatment process can significantly shorten the pre-hospital time delay after the onset of patients with acute cerebral infarction,improve the prognosis of patients,promote the recovery of patients with neurological impairment,and improve their satisfaction.
作者
皮玲丽
李丹卉
谭薇
陈晖
张继文
彭刚刚
Pi Lingli;Li Danhui;Tan Wei(The Second People′s Hospital of Shenzhen,Shenzhen Guangdong 518035,China)
出处
《齐鲁护理杂志》
2020年第6期55-58,共4页
Journal of Qilu Nursing
关键词
急性脑梗死
院前急诊
护理流程优化
院前延迟
Acute cerebral infarction
Pre-hospital emergency
Nursing process optimization
Pre-hospital delay
