摘要
目的优化急性ST段抬高型心肌梗死(STEMI)患者院内救治流程,并探讨其应用效果。方法成立多学科小组,优化急性STEMI患者心肌再灌注院内救治流程,以3C理论为引导,运用ECRSAI法对流程步骤进行剖析,制订并实施管理方案。2017年6月—12月收治的符合急性STEMI的诊断标准且接受冠状动脉介入治疗的患者76例设为对照组,采用常规院内急救流程;2018年1月—6月收治的符合标准的患者78例设为干预组,采用优化后的院内救治流程。比较2组院内救治流程各时间指标及临床结局。结果实施优化救治流程后,患者进入医院至球囊扩张(D2B)时间从87(75,105)min缩短至61.5(42.75,70)min,干预组D2B时间达标率94.87%(74/78),高于对照组63.16%(48/76),差异有统计学意义(P<0.01)。结论急性 STEMI患者院内救治流程优化后,救治效率得到明显提升。
Objective To optimize the emergency treatment process for acute ST-segment elevation myocardial infarction(STEMI). Methods A multidisciplinary team was established to design the flowchart of the myocardial ischemia reperfusion process for acute STEMI patients. Guided by the 3C theory, the method of ECRSAI(E-Eliminate;C-Combine;R-Rearrange;S-Simplify;A-Automate;I-Integrate)was adopted and related interventions was conducted. A total of 76 acute STEMI patients undergoing percutaneous coronary intervention(PCI)between June and December 2017 were set as the control group, and another 78 patients undergoing PCI between January and June 2018 were set as the intervention. The routine process of emergency treatment was adopted in the control group, and the optimized process was carried out in the intervention group. Results After the implementation of the optimized process, the door-to-balloon time was reduced from 87(75,105)min to 61.5(42.75, 70)min. The ratio of patients with the door-to-balloon time ≤ 90min increased from 63.2% to 94.9%(P<0.01). Conclusion Utilization ECRSAI method to optimize the Myocardial ischemia reperfusion process can effectively shorten the door-to-balloon time in emergency treatment of STEMI.
作者
肖丹
郭婷
涂惠
朱剑
李颐
吴洁华
杨人强
熊晓云
XIAO Dan;GUO Ting;TU Hui;ZHU Jian;LI Yi;WU Jiehua;YANG Renqiang;XIONG Xiaoyun(Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006;CCU, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006;Cardiac Catheterization Room, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006;Department of Emergency, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006;Department of Nursing, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006)
出处
《中西医结合护理（中英文）》
2019年第6期23-27,共5页
Journal of Clinical Nursing in Practice
基金
江西省“5511”科技创新人才项目(20171BCB18004)
关键词
急性ST段抬高型心肌梗死
心肌再灌注
冠状动脉介入
球囊扩张时间
肌钙蛋白
心电图
acute ST-segment elevation myocardial infarction
myocardial ischemia reperfusion
percutaneous coronary intervention
door-to-balloon time
troponin
electrocardiogram
