标题：基于三维护理管理模式的院前急救在急性脑卒中患者中的应用效果

      作者：哈茜 1，石奎 2，马汉春 1    1.汉中市人民医院急诊科，陕西 汉中 723000；2.汉中市中医医院麻醉科，陕西 汉中 723102

      卷次： 2023年34卷8期

      【摘要】 目的 探讨基于三维护理管理模式的院前急救在急性脑卒中患者中的应用效果。方法 前瞻性选取2020年1月至2021年1月汉中市人民医院急诊科收治的98例急性脑卒中患者纳入研究，按照随机数表法分为对照组和研究组各49例。对照组患者采取常规护理院前急救，研究组在对照组的护理基础上给予基于三维护理管理模式的院前急救，比较两组患者的抢救成功率、患者家属对院前急救护理人员的护理水平认可程度和总满意度，以及两组患者的活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、凝血酶原时间(PT)、纤维蛋白原(Fbg)水平。结果 研究组患者的抢救成功率为93.88% (46/49)，明显高于对照组的77.55% (38/49)，差异有统计学意义(P<0.05)；研究组家属对院前急救护理人员急救知识、快速反应能力和医护配合评分分别为(95.22±5.17)分、(96.22±5.17)分和(95.16±4.15)分，明显高于对照组的(84.13±4.17)分、(85.26±3.26)分、(84.26±2.17)分，差异均有统计学意义(P<0.05)；研究组家属对院前急救护理的总满意度为 97.83%，明显高于对照组的 84.21%，差异有统计学意义(P<0.05)；两组患者护理后的APTT、PT、TT明显高于护理前，Fbg明显低于护理前，且研究组患者护理后APTT、PT、TT明显高于对照组，Fbg明显低于对照组，差异均有统计学意义(P<0.05)。结论 基于三维护理管理模式的院前急救可提高抢救成功率、家属的护理满意度和对院前急救护理水平的认可度，改善凝血功能。
      【关键词】 三维护理管理模式；院前急救；急性脑卒中；护理；凝血
      【中图分类号】 R473.74 【文献标识码】 A 【文章编号】 1003—6350（2023）08—1179—04

Application effects of pre-hospital first aid based on three-dimensional nursing management model in patientswith acute stroke.
HA Xi 1, SHI Kui 2, MA Han-chun 1. 1. Emergency Department, Hanzhong People's Hospital, Hanzhong723000, Shaanxi, CHINA; 2. Department of Anesthesiology, Hanzhong Traditional Chinese Medicine Hospital, Hanzhong723102, Shaanxi, CHINA
【Abstract】 Objective To explore the application effects of pre-hospital first aid in acute stroke patients basedon a three-dimensional nursing management model. Methods A total of 98 patients with acute stroke admitted to theEmergency Department, Hanzhong People's Hospital from January 2020 to January 2021 were prospectively selected inthe study. The patients were divided into a control group and a study group according to the random number table meth-od, with 49 patients in each group. The patients in the control group were given routine pre-hospital first aid, while thepatients in the study group were given pre-hospital first aid based on three-dimensional nursing management mode onthe basis of the nursing in the control group. The rescue success rate of the two groups, the satisfaction of the patients'families with emergency care, the recognition of the level of pre-hospital emergency care, and the levels of activated par-tial thromboplastin time (APTT), thrombin time (TT), prothrombin time (PT), and fibrinogen (Fbg) were compared be-tween the two groups. Results The rescue success rate in the study group was 93.88% (46/49), which was significantlyhigher than 77.55% (38/49) in the control group (P<0.05). The scores of first aid knowledge, quick response ability, andmedical cooperation of pre-hospital emergency nurses in the study group were (95.22±5.17) points, (96.22±5.17) points,and (95.16±4.15) points, respectively, which were significantly higher than (84.13±4.17) points, (85.26±3.26) points,(84.26±2.17) points in the control group (P<0.05). The total satisfaction of family members in the study group to pre-hos-pital emergency care was 97.83%, significantly higher than 84.21% in the control group (P<0.05). After care, APTT, PT,and TT of patients in the two groups were significantly higher than those before care, and Fbg was significantly lower;APTT, PTT, and TT of patients in the study group were significantly higher than those of the control group, and Fbg wassignificantly lower; the differences were statistically significant (P<0.05). Conclusion Pre-hospital first aid based on3D nursing management model can improve the success rate of rescue, nursing satisfaction of family members and recog-nition level of pre-hospital first aid, and improve coagulation function.
      【Key words】 Three-dimensional nursing management model; Pre-hospital first aid; Acute ischemic stroke; Nurs-ing; Coagulation