目的 探讨循证护理在急性心肌梗死后心律失常患者中的应用效果,以期促进患者尽快康复.方法 选取2010年10月～2011年10月本院住院的符合WHO急性心肌梗死后心律失常标准的患者120例,将其随机分为循证护理组和常规护理组,各60例,常规护理组实施常规护理,循证护理组在常规护理的基础上实施循证护理措施,包括对急性心肌梗死后心律失常的时相分布特征、可控因素、心理干预措施、健康宣教等方面的偱证,用以指导临床护理.比较两组患者心律失常发生率、心功能分级、平均住院时间、平均卧床时间、平均医疗费用、患者健康知识达标率、患者满意度.结果 常规护理组心率失常发生率为66.67%,明显高于循证护理组的13.33%,两组比较差异有高度统计学意义(P ＜ 0.01);常规护理组健康知识达标率为71.67%,循证护理组为96.67%,两组比较差异有统计学意义(χ2=7.43,P ＜ 0.05).两组患者心功能分级比较差异有统计学意义(P ＜ 0.05).循证护理组患者平均住院时间为(11.02±1.01)d、平均住院费用为(5 174.95±612.30)元,均显著低于常规护理组,差异有高度统计学意义(t = 13.98、16.12,P ＜ 0.01);循证护理组平均卧床时间为(2.96±0.73)d,与常规护理组比较差异有统计学意义(t = 7.14,P ＜ 0.05).循证护理组患者满意度为96.67%,高于常规护理组的70.00%,两组比较差异有统计学意义(χ2=7.06,P ＜ 0.05).结论循证护理可有效降低急性心肌梗死后心律失常的发生,提高患者满意度,促进患者尽快康复.%Objective To investigate the application results of evidence-based care in acute myocardial infarction patients with cardiac arrhythmias, and to promote the speedy recovery of patients. Methods 120 patients who were in line with WHO acute myocardial infarction arrhythmia standard were selected from October 2010 to October 2011 and were randomly divided into evidence-based care group and usual care group of 60 patients in each, usual care group were given routine care, evidence-based care group were given evidence-based care on the basis of the usual care, which included acute myocardial infarction arrhythmias phase distribution, controllable factors, psychological interventions, health education and other aspects. The incidence of arrhythmia, cardiac function, the average length of stay, average time in bed, the average medical costs, health knowledge and compliance rates of patients, patient satisfaction were compared between the two groups. Results The incidence of arrhythmia in usual care group was 66.67%, which was significantly higher than 13.33% of the evidence-based care group, the difference was highly statistically significant (P < 0.01); the health knowledge compliance rate of the usual care group was 71.67%, the evidence-based care group was 96.67%, the difference was statistically significant (χ2=7.43, P < 0.05). The functional class of two groups patients was significantly different (P < 0.05). The average length of stay of evidence-based care group patients were (11.02±1.01) days, the average hospital costs were (5 174.95±612.30) yuan, which were significantly lower than those of the usual care group, the differences were highly statistically significant (t = 13.98, 16.12, P < 0.01 ); the average bed time of evidence-based care group were (2.96± 0.73) days, compared with the usual care group, the difference was statistically significant (t = 7.14, P <0.05). The patients' satisfaction of evidence-based care group was 96.67%, which was higher than 70.00% of the usual care group, the differ ence was statistically significant (χ2=7.06, P < 0.05). Conclusion Evidence-based care can effectively reduce the acute myocardial infarction arrhythmia, improve patients' satisfaction, and promote the speedy recovery of patients.
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