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临床护理路径在重型脑卒中急救中的应用效果
基金项目:浙江省自然科学基金项目(LY15H090004)
摘    要:目的探讨临床护理路径在重型脑卒中急救中的应用效果。方法选择2016年1月~2017年6月在我院急诊科急救的重型脑卒中患者120例为研究对象,随机分为干预组与对照组各60例。对照组给予常规急诊护理,干预组采用临床护理路径。比较两组自接诊至确诊时间、抢救时间、抢救费用、平均住院时间、平均住院费用、住院期间并发症、入院时及住院7 d两组患者GCS评分。结果干预组接诊至确诊时间、抢救时间显著短于对照组,护理抢救费用显著低于对照组,差异有统计学意义(P0.05)。干预组平均住院时间较对照组短,差异有统计学意义(P0.05);两组平均住院费用比较差异无统计学意义(P0.05)。干预组肺部感染、尿路感染的发生率显著低于对照组,差异有统计学意义(P0.05)。两组治疗7 d后GCS评分均显著提高,差异有统计学意义(P0.05);治疗7 d后两组GCS评分比较差异无统计学意义(P0.05)。结论重型脑卒中急救中使用临床护理路径能够缩短接诊至确诊时间、抢救时间、住院时间,降低抢救费,减少住院并发症。

关 键 词:重型脑卒中  急救  临床护理路径  应激性溃疡

Application effect of clinical nursing pathway in the emergency rescue for severe stroke
Abstract:Objective To explore the application effect of clinical nursing pathway in the emergency rescue for severestroke. Methods From January 2016 to June 2017, 120 patients with severe stroke in the emergency department of our hospital were selected as the study subjects. The patients were randomly divided into intervention group and control group, with 60 cases in each group. The control group was given routine emergency care, and the control group was given clinical nursing pathway. The time from consultation to diagnosis, rescue time, rescue costs, average length of stay, average hospitalization costs, complications during hospitalization, GCS scores upon admission and 7 days after admission were compared between the two groups. Results The time from consultation to diagnosis and rescue time in the intervention group were significantly shorter than those in the control group, and the rescue cost was significantly lower than that in the control group, the differences were statistically significant(P<0.05). The average length of stay in the intervention group was shorter than that in the control group, and the difference was statistically significant(P<0.05); there was no statistically significant difference in the average hospitalization costs between the two groups(P>0.05). The incidence rates of pulmonary infections and urinary tract infections in the intervention group were significantly lower than those in the control group, and the differences were statistically significant(P<0.05); the GCS scores in both groups were increased significantly 7 days after the treatment, and the difference was statistical significant (P<0.05); there was no statistically significant difference in GCS scores between the two groups 7 days after the treatment (P>0.05). Conclusion The use of clinical nursing pathways in the emergency rescue for severe stroke can shorten the time from consultation to diagnosis, rescue time and length of stay, reduce the cost of rescue and reduce the complications during hospitalization.
Keywords:Severe stroke   Rescue   Clinical nursing pathway   Stress ulcer
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