卒中护士参与缺血性脑卒中患者静脉溶栓救治流程再造的效果观察

目的 探讨卒中护士参与缺血性脑卒中患者静脉溶栓救治流程再造的效果,提出有效的流程优化措施。 方法 回顾性分析2018年1月—2020年2月绍兴市人民医院收治的128例缺血性脑卒中患者。根据入院时间分组:2018年1月—2019年1月实施常规静脉溶栓救治流程的64例纳入对照组,2019年2月—2020年2月实施卒中护士参与静脉溶栓救治流程再造的64例纳入研究组。比较2组救治效果。 结果 研究组接诊到CT检查时间、CT检查到溶栓治疗时间、接诊到溶栓治疗时间分别为(12.05±6.23)min、(18.89±9.21)min、(30.52±8.01)min,均短于对照组(15.85±7.51)min、(28.62±8.75)min、(45.62±9.51)min,t=3.115、6.127、9.715,均P<0.05];溶栓后2周,研究组NIHSS、mRS评分分别为(9.21±3.52)分、(1.92±0.52)分,低于对照组(10.54±4.24)分、(2.25±0.66)分,t=1.931、3.142,P=0.028、0.001];研究组静脉溶栓并发症发生率为1.56%,低于对照组的12.50%(χ2=4.302,P=0.038);研究组病死率为1.56%,对照组为4.69%(χ2=0.258,P=0.611);研究组护理满意度为98.44%,高于对照组的85.94%(χ2=6.942,P=0.008)。 结论 对于缺血性脑卒中患者实施卒中护士参与的静脉溶栓救治流程再造可缩短急诊溶栓各环节时间,改善救治效果,减少并发症发生,提升患者护理满意度。 

Observation on the effect of stroke nurses participating in the reconstruction of thrombolysis treatment process in patients with ischemic stroke

Objective To investigate the effect of stroke nurses' participation in venous thrombolysis treatment process reengineering in patients with ischemic stroke and to propose effective process optimization measures. Methods From January 2018 to February 2020, 128 patients with ischemic stroke in Shaoxing People's Hospital were analyzed retrospectively. According to the time of admission, 64 patients with routine intravenous thrombolysis from January 2018 to January 2019 were included in the control group, and 64 patients with stroke nurses' participating in the reconstruction of intravenous thrombolysis from February 2019 to February 2020 were included in the study group. The therapeutic effects of the two groups were compared. Results The time from diagnosis to CT examination, from CT examination to thrombolysis and from diagnosis to thrombolysis were(12.05±6.23) min,(18.89±9.21) min, and(30.52±8.01) min in the study group, which were shorter than those from the control group(15.85±7.51) min,(28.62±8.75) min, and(45.62±9.51) min, respectively(t=3.115, 6.127, 9.715, all P<0.05). Two weeks after thrombolysis, the NIHSS and mRS scores of the study group were(9.21±3.52) points and(1.92±0.52) points, which were lower than those of the control group(10.54±4.24) points and(2.25±0.66) points, respectively(t=1.931, 3.142, P=0.028, 0.001). The incidence of venous thrombolytic complications in the study group was 1.56%, lower than that in the control group 12.50%(χ2=4.302, P=0.038). The mortality rate was 1.56% in study group and 4.69% in control group(χ2=0.258, P=0.611). The nursing satisfaction in the study group was 98.44%, higher than 85.94% in the control group(χ2=6.942, P=0.008). Conclusion The reconstruction of thrombolysis treatment process involved by stroke nurses can shorten the time of thrombolysis, improve the effect of treatment, reduce complications, improve the satisfaction of patients, and reduce the mortality.