“白金十分钟”救护模式在AMI患者院前急救护理中的应用及对临床转归的影响

目的　探讨“白金十分钟”救护模式在急性心肌梗死（AMI）患者院前急救护理中的应用及对临床转归的影响。方法　将聊城市人民医院院前急救部2020年7月至2021年8月期间收治的100例AMI患者按照随机数表字法分为对照组（45例）和研究组（55例），对照组男、女分别为23例、22例，年龄（55.59±5.78）岁；研究组男、女分别为26例、29例，年龄（55.77±5.62）岁；对照组给予常规AMI患者院前急救护理，研究组在上述基础实施“白金十分钟”救护模式。比较两组患者的抢救情况（院前急救反应时间、分诊评估时间、首次心电图采集时间、住院时间）、并发症发生情况，以及护理前后心功能指标、生活质量。采用t、χ²检验。结果　研究组院前急救反应时间、首次心电图采集时间、分诊评估时间、住院时间分别为（2.35±0.42）min、（7.97±1.39）min、（1.88±0.24）min、（12.58±2.51）d，均短于对照组［分别为（5.63±1.05）min、（12.78±2.45）min、（3.42±0.60）min、（17.52±3.22）d］，两组比较，差异均有统计学意义（t=21.204、12.341、17.423、8.621，均P<0.001）；研究组并发症总发生率［3.64%（2/55）］较对照组［17.78%（8/45）］显著降低（χ²=5.499，P=0.019）。护理前，两组患者左心室舒张末期内径（LVEDD）、左心射血分数（LVEF）、左心室收缩末期内径（LVESD）比较，差异均无统计学意义（均P>0.05）；护理后，研究组患者LVEDD、LVESD分别为（52.16±6.08）mm、（41.39±4.68）mm，均低于对照组［（58.79±6.34）mm、（46.98±5.12）mm］，研究组LVEF为（58.76±7.42）%，高于对照组的（53.64±6.12）%，两组比较差异有统计学意义（t=5.322、5.696、3.709，均P<0.001）。护理前，两组患者身体疼痛、社会职能、情感职能、生理功能评分比较，差异均无统计学意义（均P>0.05）；护理后，研究组上述评分分别为（63.07±7.89）分、（65.37±7.06）分、（72.31±7.86）分、（70.34±7.15）分，均高于对照组［（56.31±7.22）分、（60.14±6.42）分、（66.13±6.19）分、（65.68±6.72）分］，两组比较差异均有统计学意义（t=4.427、3.838、4.295、3.331，均P<0.001）。结论　AMI患者院前急救护理应用“白金十分钟”护理模式，干预效果明显，能显著提高医护人员的急救效率，降低患者并发症发生情况，改善心功能，提高生活质量看，进一步促进患者转归。

Application of platinum ten-minute ambulance mode in pre-hospital emergency care for patients with AMI and its impact on clinical outcomes

Objective　To investigate the application of platinum ten-minute ambulance mode in pre-hospital emergency care for patients with acute myocardial infarction (AMI) and its impact on clinical outcomes. Methods　One hundred patients with AMI admitted to Pre-hospital Emergency Department, Liaocheng People's Hospital between July 2020 and August 2021 were selected. They were divided into a control group (45 cases) and a study group (55 cases) by the random number table method. There were 23 males and 22 females in the control group, and they were (55.59±5.78) years old. There were 26 males and 29 females in the study group, and they were (55.77±5.62) years old. The control group received routine pre-hospital emergency care, and the study group were intervened by the platinum ten-minute ambulance mode. The rescue statuses (response time of pre-hospital first aid, triage assessment time, first electrocardiogram collection time, and hospital stay), complications, cardiac function indicators, and qualities of life were compared between the two groups. t test and χ² test were used. Results　The response time of pre-hospital first aid, first electrocardiogram collection time, triage assessment time, and hospital stay in the study group were shorter than those in the control group (2.35±0.42)min vs. (5.63±1.05) min, (7.97±1.39) min vs. (12.78±2.45) min, (1.88±0.24) min vs. (3.42±0.60) min, and (12.58±2.51) d vs. (17.52±3.22) d], with statistical differences (t=21.204, 12.341, 17.423, and 8.621; all P<0.001). The total incidence of complications in the study group was significantly lower than that in the control group 3.64% (2/55) vs. 17.78% (8/45); χ²=5.499, P=0.019]. Before the nursing, there were no statistical differences in the left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), and left ventricular end systolic diameter (LVESD) between these two groups (all P>0.05). After the nursing, the LVEDD and LVESD were lower and the LVEF was higher in the study group (52.16±6.08) mm vs. (58.79±6.34) mm, (41.39±4.68) mm vs. (46.98±5.12) mm, and (58.76±7.42)% vs. (53.64±6.12)%], with statistical differences (t=5.322, 5.696, and 3.709; all P<0.001). Before the nursing, there were no statistical differences in the scores of physical pain, social role, emotional role, and physiological function between these two groups (all P>0.05). After the nursing, the scores of physical pain, social role, emotional role, and physiological function in study group were higher than those in the control group (63.07±7.89) vs. (56.31±7.22), (65.37±7.06) vs. (60.14±6.42), (72.31±7.86) vs. (66.13±6.19), and (70.34±7.15) vs. (65.68±6.72)], with statistical differences (t=4.427, 3.838, 4.295, and 3.331; all P<0.001). Conclusion　Applying platinum ten-minute ambulance mode in pre-hospital emergency care for patients with AMI can achieve obvious intervention effect, significantly improve the efficiency of first aid and the patients' cardiac function, quality of life, and clinical outcomes, and reduce the incidence of complications.