摘要
目的探讨改良早期预警评分(MEWS)联合失效模式与效应分析(FMEA)急救护理模式对急性心肌梗死(AMI)患者急救效率及不良事件的影响。方法选取2024年2月—2025年2月急诊收入新疆医科大学第一附属医院的296例AMI患者作为研究对象,采用随机数字表法将患者分为对照组与试验组,每组148例。对照组接受常规急救,试验组在对照组的基础上联合采用MEWS和FMEA措施。比较两组患者的急救效率、不良事件发生率等。结果试验组静脉通路搭建时间[(8.42±1.03)min]、肌钙蛋白检测时间[(18.67±3.14)min]、心电图出具时间[(5.86±1.05)min]、经皮冠状动脉介入治疗时间[(61.52±10.43)min]均短于对照组[分别为(11.12±1.86)、(22.86±4.67)、(7.84±1.22)、(86.54±11.73)min](t=15.449、9.058、14.965、19.392,均P<0.05)。试验组梗死血管再通率(91.89%)高于对照组(83.78%)(χ^(2)=4.554,P<0.05)。试验组左心室舒张末期内径(47.02±3.11 mm)低于对照组(49.88±3.08 mm)(t=7.949,P<0.05),左室射血分数[(51.92±4.67)%]与二尖瓣E峰值/A峰值[(1.19±0.41)]均高于对照组[(48.12±3.48)%、(0.89±0.38)](t=7.938、9.261,均P<0.05)。试验组不良事件总发生率(2.70%)低于对照组(8.78%)(χ^(2)=5.055,P<0.05)。试验组满意率(99.32%)与对照组满意率(95.27%)比较,差异无统计学意义(χ^(2)=3.121,P>0.05)。结论MEWS联合FMEA模式可显著缩短AMI患者急诊救治时间,提高梗阻血管再通率,改善患者心功能,降低患者不良事件发生率,提高护理满意度。
Objective To investigate the impact of the modified early warning score(MEWS)combined with failure mode and effects analysis(FMEA)on emergency-care efficiency and adverse events in patients with acute myocardial infarction(AMI).Methods A total of 296 patients with acute myocardial infarction(AMI)admitted to the First Affiliated Hospital of Xinjiang Medical University from February 2024 to February 2025 were selected as research subjects.Using a random number table method,the patients were divided into a control group and an experimental group,with 148 patients in each group.The control group received routine emergency treatment,while the experimental group was given additional MEWS and FMEA measures on the basis of the control group's treatment.Indicators including emergency treatment efficiency and the incidence of adverse events were compared between the two groups.Results In the experimental group,the time for establishing intravenous access[(8.42±1.03)min],troponin detection time[(18.67±3.14)min],electrocardiogram(ECG)report time[(5.86±1.05)min],and percutaneous coronary intervention(PCI)time[(61.52±10.43)min]were all significantly shorter than those in the control group[(11.12±1.86)min,(22.86±4.67)min,(7.84±1.22)min,(86.54±11.73)min](t=15.449,9.058,14.965,19.392,all P<0.05).The recanalization rate of infarcted blood vessels in the experimental group(91.89%)was higher than that in the control group(83.78%)(χ^(2)=4.554,P<0.05).The left ventricular end-diastolic diameter(LVEDD)in the experimental group(47.02±3.11)mm was lower than that in the control group(49.88±3.08 mm)(t=7.949,P<0.05);meanwhile,the left ventricular ejection fraction(LVEF)[(51.92±4.67)%]and mitral valve E wave/A wave ratio(1.19±0.41)in the experimental group were higher than those in the control group[(48.12±3.48)%,(0.89±0.38)](t=7.938,9.261,both P<0.05).The total incidence of adverse events in the experimental group(2.70%)was lower than that in the control group(8.78%)(χ^(2)=5.055,P<0.05).There was no statistically significant difference in the satisfaction rate between the experimental group(99.32%)and the control group(95.27%)(χ^(2)=3.121,P>0.05).Conclusion MEWS combined with FMEA integration significantly reduces emergency care delays,improves revascularization rates and cardiac function,decreases adverse events,and enhances patient satisfaction in AMI management.
作者
郭璇
杨建中
许姗姗
董辉
马晶晶
张莉
GUO Xuan;YANG Jianzhong;XU Shanshan;DONG Hui;MA Jingjing;ZHANG Li(Department of Nursing,the First Affiliated Hospital of Xinjiang Medical University,Urumqi Xinjiang Uygur Autonomous Region 830054,China)
出处
《中国急救复苏与灾害医学杂志》
2026年第3期392-396,共5页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
新疆维吾尔自治区自然科学基金资助项目(面上项目)(2024D01C175)。
关键词
急性心肌梗死
早期预警评分
失效模式与效应分析
不良事件
急救效率
Acute myocardial infarction
Early warning score
Failure mode and effects analysis
Adverse events
Emergency efficiency
