标题：基于FMEA模型的预见性护理在脑血管介入术患者中的应用

      作者：龚俊，苗锐，李露，成毅    陕西省第二人民医院神经内科，陕西 西安 710005

      卷次： 2024年35卷10期

      【摘要】 目的 研究基于失效模式和效应分析(FMEA)模型的预见性护理在脑血管介入术患者中的应用效果。方法 前瞻性选取2021年1月至2023年12月在陕西省第二人民医院拟接受脑血管介入术治疗的102例患者作为研究对象，按随机数表法分为观察组和对照组各51例，对照组患者采用常规护理，观察组患者在对照组护理的基础上采用基于FMEA模型的预见性护理。持续护理至患者出院，比较两组患者的置管时间、卧床时间、住院时间以及 ICU入住情况；分别于术前、出院时，比较两组患者的D-二聚体(D-D)、超敏Ｃ反应蛋白(hs-CRP)水平；出院时采用自制调查问卷调查两组患者和护理满意度；出院时，统计分析两组患者并发症发生情况，并采用生活质量评价量表(SF-36)评估两组患者术后生活质量恢复情况。结果 观察组患者的置管时间、卧床时间、住院时间、ICU入住率分别为(4.67±0.78) d、(3.63±1.74) d、(9.67±1.45) d、3.92%，明显短(低)于对照组的(6.39±1.24) d、(5.53±1.26) d、(13.39±2.25) d、21.57%，差异均有统计学意义(P<0.05)；术前，两组患者D-D、hs-CRP比较差异均无统计学意义(P>0.05)；出院时，观察组患者的D-D、hs-CRP水平分别为(0.29±0.15) mg/L、(3.48±0.45) mg/L，明显低于对照组的(0.57±0.44) mg/L、(6.97±1.40) mg/L，差异均有统计学意义(P<0.05)；出院时观察组患者对护理的总满意度为94.12%，明显高于对照组的80.39%，差异有统计学意义(P<0.05)；出院时，观察组患者的并发症总发生率为5.88%，明显低于对照组的29.41%，观察组患者SF-36各项得分明显高于对照组，差异均有统计学意义(P<0.05)。结论 基于FMEA模型的预见性护理可显著降低脑血管介入术后患者的并发症发生率，促进改善患者临床结局，提升患者护理满意度。
      【关键词】 失效模式；效应分析；脑血管介入术；并发症；预见性护理
      【中图分类号】 R473.74 【文献标识码】 A 【文章编号】 1003—6350（2024）10—1499—05

Application of predictive nursing based on FMEA model in patients undergoing cerebrovascular interventionalsurgery.
GONG Jun, MIAO Rui, LI Lu, CHENG Yi. Department of Neurology, the Second People's Hospital of ShaanxiProvince, Xi'an 710005, Shaanxi, CHINA
【Abstract】 Objective To study the effect of predictive nursing based on failure mode and effect analysis(FMEA) model in patients undergoing cerebrovascular interventional surgery. Methods A total of 102 patients whowere scheduled to receive cerebrovascular interventional therapy in the Second People's Hospital of Shaanxi Provincefrom January 2021 to December 2023 were prospectively selected and divided into the observation group and the controlgroup according to random number table method, with 51 patients in each group. Patients in the control group were treat-ed with routine nursing, and those in the observation group were treated with predictive nursing based on FMEA model,continuously until discharge. The catheterization time, bed time, length of hospital stay, and ICU admission of the twogroups were compared. The levels of D-dimer (D-D) and hypersensitive C-reactive protein (hs-CRP) were compared be-tween the two groups before and at discharge. At discharge, self-made questionnaire was used to investigate the patients'satisfaction with nursing. The incidence of complications in the two groups were statistically analyzed, and the recoveryof postoperative quality of life in the two groups was evaluated by 36-item Short-Form (SF-36). Results The catheter-ization time, bed time, length of hospital stay, and ICU admission rate in the observation group were (4.67 ± 0.78) d,(3.63±1.74) d, (9.67±1.45) d, and 3.92%, respectively, significantly shorter (lower) than (6.39±1.24) d, (5.53±1.26) d,(13.39 ± 2.25) d, and 21.57% in the control group. Before surgery, there were no significant differences in D-D andhs-CRP levels between the two groups (P>0.05); at discharge, the levels in the observation group were (0.29±0.15) mg/Land (3.48±0.45) mg/L, which were significantly lower than (0.57±0.44) mg/L and (6.97±1.40) mg/L in the control group(P<0.05). At discharge, the patients' total satisfaction with nursing in the observation group was 94.12%, which was sig-nificantly higher than 80.39% in the control group (P<0.05); the total complication rate in the observation group was5.88%, which was significantly lower than 29.41% in the control group; the scores of SF-36 in the observationgroup were significantly higher than those in the control group; the differences were statistically significant (P<0.05). Conclusion Predictive nursing based on FMEA model can significantly reduce the incidence of complicationsafter cerebrovascular intervention, promote the improvement of patient clinical outcomes, and enhance patients' satisfac-tion with nursing.
      【Key words】 Failure mode; Effect analysis; Cerebrovascular intervention; Complications; Predictive nursing