摘要
目的 探讨急诊护理路径用于中西医结合治疗脑梗死患者预后的影响。方法 将2020年1月—2021年12月在该院急诊科治疗的164例急性脑梗死患者按不同急诊护理路径分为两组,对照组(n=72)为2020年接诊患者,均未开通绿色通道,观察组(n=92)为2021年接诊患者,均开通绿色通道,两组均给予中西医结合治疗(西医综合用药治疗+中医辨证用药治疗),连续医治2周后,对比接诊至救治各指标、救治效果、神经功能各指标、各项血清因子变化、中医证候积分。结果 观察组接诊至确诊时间、确诊至接受治疗时间、接诊至治疗总用时、住院时间、住院费用、住院期间病死率均低于对照组(P<0.05);观察组治疗有效率为93.48%,明显高于对照组的77.78%(P<0.05);治疗2周后的美国国立卫生院神经功能缺损评分(national institute of health stroke scale,NIHSS)、巴塞尔指数(barthel index,BI)、运动功能评估量表(fugl-meyer assessment,FMA)评分相比,观察组NIHSS评分下降更显著,而BI指数、FMA评分升高更明显(P<0.05);治疗后两组超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、同型半胱氨酸(homocysteine,Hcy)、D-二聚体(D-dimer,DD)、神经元特异性烯醇化酶(neuron specific enolase,NSE)、基质金属蛋白酶9(matrix metalloproteinase-9,MMP-9)水平相比,均明显降低,但观察组下降更多,而治疗后观察组血管内皮生长因子(VEGF)水平升高更多(P<0.05);治疗后观察组神志昏蒙、口眼歪斜、偏身不利、言语謇涩或失语、神疲乏力等各项证候积分均更低(P<0.05)。结论 急诊护理路径用于中西医结合治疗脑梗死的效果显著,有助于提升整体疗效,缩短急诊救治时间,改善神经功能,降低病死率,对预后有积极的影响。
Objective To explore the impact of emergency nursing pathway on the prognosis of patients with cerebral infarction treated with integrated traditional Chinese and Western medicine.Methods 164 patients with acute cerebral infarction treated in the emergency department of our hospital from January 2020 to December 2021 were divided into two groups according to different emergency care paths.The control group(n=72)was the patients received in 2020,and none of them had opened the green channel.The observation group(n=92)was the patients received in 2021,and all of them had opened the green channel.Both groups were treated with integrated traditional Chinese and Western medicine(Western medicine combined with traditional Chinese medicine based on syndrome differentiation).After two weeks of continuous treatment,the indexes from reception to treatment,treatment effect,neurological indexes,changes of serum factors and TCM syndrome scores were compared.Results The time from reception to diagnosis,the time from diagnosis to treatment,the total time from reception to treatment,the length of hospital stay,the cost of hospitalization and the mortality during hospitalization in the observation group were lower than those in the control group(P<0.05);The effective rate of the observation group was 93.48%,significantly higher than 77.78%of the control group(P<0.05);Compared with the National Institute of Health Stroke Scale(NIHSS),Basel index(BI),and Fugl-Meyer Assessment(FMA)scores after 2 weeks of treatment,the NIHSS score in the observation group decreased more significantly,while the BI index and FMA scores increased more significantly(P<0.05);After treatment,the levels of hypersensitive C-reactive protein(hs-CRP),homocysteine(Hcy),D-dimer(DD),neuron specific enolase(NSE),and matrix metalloproteinase-9(MMP-9)in both groups were significantly lower,but the observation group decreased more,while the observation group increased more VEGF levels after treatment(P<0.05);After treatment,the scores of various syndromes in the obse
作者
李影
王苏丽
姚茹
LI Ying;WANG Suli;YAO Ru(Air Force 986 Hospital,Xi’an 710054,Shaanxi,China)
出处
《辽宁中医药大学学报》
CAS
2023年第6期158-162,共5页
Journal of Liaoning University of Traditional Chinese Medicine
基金
陕西省中医药管理局项目(2021-ZZ-LC030)。
关键词
脑梗死
中西医结合治疗
急诊护理路径
疗效
预后
cerebral infarction
integrated traditional Chinese and Western medicine
emergency nursing path
curative effect
prognosis
