陈楚红 李亚轩 高凯丽 张海君 廖鹤茱

【摘要】 目的：探討优化急诊护理流程在抢救心肌梗死患者中的应用及对患者死亡率的影响。方法：选择2018年9月-2020年8月心肌梗死抢救患者60例为研究对象。采用随机数字表法将患者分为对照组和观察组，每组30例。对照组采用常规护理，观察组联合优化急诊护理流程。比较两组日常生活能力、运动功能、生活质量、救治效果及满意度。结果：观察组患者急诊时间、给抗凝药物时间、首份心电图完成时间、PCI时间、输液通道时间均短于对照组，住院费用少于对照组，差异均有统计学意义（P<0.05）。护理后，两组BI、Fugl-Meyer和SF-36量表评分均高于护理前，且观察组的BI、Fugl-Meyer和SF-36量表评分均高于对照组，差异均有统计学意义（P<0.05）。观察组急救成功率和急救方法、急救形式及急救流程的满意度均高于对照组，死亡率及残疾率均低于对照组，差异均有统计学意义（P<0.05）。结论：优化急诊护理流程用于抢救心肌梗死患者中能缩短抢救时间，提高患者日常生活和运动能力，获得较高的救治效果和护理满意度，值得推广应用。

【关键词】 优化急诊护理流程 心肌梗死 抢救患者 护理效果 死亡率

Study on the Effect of Optimizing Emergency Nursing Process in the Rescue of Patients with Myocardial Infarction and Its Impact on Mortality/CHEN Chuhong， LI Yaxuan， GAO Kaili， ZHANG Haijun， LIAO Hezhu. //Medical Innovation of China， 2021， 18（14）： -117

[Abstract] Objective： To explore the application of optimizing emergency nursing procedure in the rescue of patients with myocardial infarction and its effect on the mortality of patients. Method： A total of 60 patients with myocardial infarction who were rescued from September 2018 to August 2020 were selected as the research subjects. The patients were divided into control group and observation group by random number table method， 30 cases in each group. The control group was treated with routine care， and the observation group was combined to optimize the emergency care process. The daily living ability， motor function， quality of life， treatment effect and satisfaction were compared between the two groups. Result： The time of emergency treatment， administration of anticoagulant drugs， completion time of the first electrocardiogram， PCI time and infusion channel time in the observation group were all shorter than those in the control group， and the cost of hospitalization was less than that in the control group， the differences were statistically significant （P<0.05）. After nursing， BI， Fugl-Meyer and SF-36 scores in both groups were higher than those before nursing， and BI， Fugl-Meyer and SF-36 scores in the observation group were higher than those in the control group， the differences were statistically significant （P<0.05）. The first aid success rate， first aid method， first aid form and first aid procedure satisfaction of the observation group were higher than those of the control group， and the death and disability rates were lower than those of the control group， the differences were statistically significant （P<0.05）. Conclusion： Optimized emergency nursing process can shorten the rescue time of patients with myocardial infarction， improve patients daily life and exercise ability， and obtain higher treatment effect and nursing satisfaction， which is worthy of popularization and application.

[Key words] Optimize emergency nursing process Myocardial infarction Rescue Nursing effect Mortality

First-authors address： Zhanjiang First Hospital of Traditional Chinese Medicine， Zhanjiang 524300， China

doi：10.3969/j.issn.1674-4985.2021.14.028

心肌梗死是由于各種原因引起的冠状动脉急性、持续性缺氧或缺血，导致心肌坏死，患者发病时临床多表现为胸骨后疼痛，持续时间较长[1]。同时，随着病情的不断发展，部分患者可伴有心电图异常，增加了心律失常、休克的发生率，具有较高的临床死亡率[2-3]。因此，心肌梗死患者确诊后应及时进行救治，并做好临床护理干预，以提高抢救成功率，降低临床死亡率[4]。传统就诊流程虽然能满足患者抢救需要，但是所需时间较长，对于存活患者亦存在较高的后遗症发生率，导致患者预后较差[5-6]。优化急诊护理流程是在传统救治基础上对患者抢救流程进行优化，改善院前急救方案，充分发挥首诊负责制优势，做好急诊交接相关内容，有助于提升急救护理质量[7-8]。但是，该护理方法对抢救心肌梗死患者中死亡率的影响研究较少。……