非ST段抬高型急性冠脉综合征急诊护理分诊技术探讨

目的探讨非ST段抬高型急性冠脉综合征(NSTE-ACS)的急诊分诊技术,提高NSTE-ACS分诊质量。方法检索近10年国内外NSTE-ACS诊疗指南及相关护理分诊文献。将NSTE-ACS中有关的临床表现特征、鉴别诊断、生物标志物采集时机、护理监测培训等相关文献纳入研究。参与研究的护士重点研读NSTE-ACS的各种症状与鉴别诊断、NSTE-ACS相关心电图特征及心肌损伤标志物研究进展。对获得的信息归纳分析,建立症状鉴别表与危险因素分层表。结果建立了NSTE-ACS高度疑似患者、疑似患者及非ACS患者症状的鉴别表、NSTE-ACS典型症状与非典型症状快速分诊表、危险分层分诊表及hs-cTn 0 h/1 h分诊流程。结论NSTE-ACS症状鉴别、危险分层分诊表及hs-cTn 0 h/1 h分诊流程的建立有助于引导NSTE-ACS急诊分诊技术发展。

Discussion on emergency nursing triage technology of non-ST-segment elevation of acute coronary syndrome

Objective To explore the emergency triage technology of non-ST-segment elevation of acute coronary syndrome(NSTE-ACS)to improve the quality of NSTE-ACS triage.Methods The diagnosis and treatment guidelines and related nursing triage literature of NSTE-ACS were searched in the past 10 years.The relevant literatures such as clinical manifestations,differential diagnosis,timing of biomarker collection,and training of nursing monitoring in NSTE-ACS were included in the study.The participating nurses focused on studying the various symptoms and differential diagnosis of NSTE-ACS,NSTE-ACS-related ECG features,and research progress on myocardial injury markers.We analyzed the information obtained,and established a symptom identification table and a risk factor hierarchical table.Results We developed the identification table for the symptoms of highly suspected patients,suspected patients and non-ACS patients with NSTE-ACS,the rapid classification table of typical and atypical symptoms of NSTE-ACS,the risk stratification classification table and hs-cTn 0 h/1 h triage process.Conclusion The establishment of NSTE-ACS symptom identification,risk stratification triage table and hs-cTn 0 h/1 h triage process could help guide the development of NSTE-ACS emergency triage technology.