密芳　庞志敏　刘雨佳　张菁

[关键词] 一体化链式急救模式;大咯血;支气管动脉栓塞术;效果评价;满意度

[中图分类号] R473.5          [文獻标识码] B          [文章编号] 1673-9701（2021）23-0177-04

Application of integrated chain emergency mode in patients with massive hemoptysis undergoing bronchial artery embolization

MI Fang   PANG Zhimin   LIU Yujia   ZHANG Jing

Department of Respiratory Medicine，Zaozhuang Mining Group Central Hospital，Zaozhuang   277800，China

[Abstract] Objective To explore the application effect of the integrated chain emergency nursing mode in patients with massive hemoptysis undergoing bronchial artery embolization.Methods 35 patients admitted from January to December 2018 were set as the control group，and they underwent the traditional emergency care mode.35 patients from January to December 2019 were set as the observation group，and they underwent the integrated chain emergency care mode.The emergency time，pre-hospital accidents，surgical results，anxiety，and nursing satisfaction between the two groups were compared. Results The first aid time of the observation group was shorter than that of the control group，and the difference was statistically significant （P<0.05）.The incidence of preoperative adverse events in the observation group was lower than that of the control group，and the difference was statistically significant （χ2=4.172，P<0.05）.The surgical effect of the observation group was higher than that in the control group，and the difference was statistically significant （χ2=5.113，P<0.05）.The anxiety of the observation group was lower than that of the control group （t=3.632，P<0.05）.And the nursing satisfaction was higher than that of the control group.The difference was statistically significant （t=4.861，P<0.05）. Conclusion The implementation of integrated chain emergency nursing mode for patients with massive hemoptysis undergoing bronchial artery embolization can significantly shorten the patient's treatment time，reduce the occurrence of adverse events，improve the treatment effect.At the same time，it can improve the patient's anxiety and increase nursing satisfaction.

[Key words] Integrated chain emergency mode;Massive hemoptysis;Bronchial artery embolization;Effect evaluation;Satisfaction

咯血是呼吸内科常见急症，常见于气管支气管、肺组织及肺血管、心血管等疾病。大咯血指一次咯血量达100 mL以上或24 h内咯血600 mL以上，可因引发失血性休克或窒息而致患者于死亡高风险威胁状态，需立即展开积极救治[1-2]。经导管支气管动脉栓塞术（Bronchial arterial embolization，BAZ）现已成为临床急性大咯血首选治疗方法，即刻止血有效率73%～98%，为后期胸外科手术赢得时间。研究报道：急救护理质量与大咯血患者生命及预后密切相关，故而探讨适用于大咯血患者的护理急救模式势在必行[3]。一体化链式急救护理模式是近年来应用较广泛的新型急救护理模式，具有程序化、规范化及标准化特点，可通过高效的救护程序及专业的救护技能实现救护效果最大化[4]。本研究将此模式应用到大咯血行BAZ患者急救中，现报道如下。

1 资料与方法

1.1一般资料

回顾分析本院2018年1月至2019年12月收治的70例大咯血且行BAZ患者为研究对象。纳入标准： 符合大咯血诊治标准[5]：即出血量>200 mL/h或24 h内>600  mL且威胁生命的咯血;所有患者均自愿参与。排除标准：有BAE禁忌证，如造影剂过敏、甲状腺功能亢进、凝血功能障碍;严重心、肝、肾功能不全;有精神疾病或认知障碍者。按照入院先后顺序将2018年1～12月收治的35例患者设为对照组，其中男19例，女16例，年龄26～76岁，平均（62.72±7.57）岁，24 h咯血量（702.36±51.02）mL，疾病类型：支气管扩张17例，肺结核5例，肺癌13……