GRACE评分系统应用于急性冠脉综合征患者围手术期的护理效果

摘要

目的：分析基于GRACE评分系统的急诊专科护理模式在急性冠脉综合征（ACS）患者围手术期的应用效果。方法连续选择2013年9月~2015年3月于中国人民解放军总医院急诊科诊断为ACS患者265例，男性138例，女性127例，年龄39~75岁。根据入院先后顺序，随机将其分为对照组（132例）和观察组（133例）。对照组采用标准专科护理模式，观察组采用基于GRACE评分系统的专科护理模式，对比两组的入院至球囊扩张（door-to-balloon，D-to-B）时间、手术时间和住院时间，手术相关并发症发生率和护理满意度评分。结果观察组的D-to-B时间、手术时间和住院时间较对照组显著缩短，数值为[（27.8±13.2）min vs.（45.6±16.4）min]、[（42.6±15.5）min vs.（58.7±16.9）min]、[（7.8±2.4）d vs.（10.5±2.3）d]，差异均有统计学意义（P均＜0.05）。观察组手术相关并发症发生率显著低于对照组（10.5% vs.23.5%），差异有统计学意义（P＜0.05）。观察组的护理满意度各项评分均显著高于对照组，差异有统计学意义（P均＜0.05）。结论应用GRACE评分系统对ACS患者进行分层护理，可明显缩短入院至救治时间，减少并发症，提升护理质量。%Objective To analyze the application effect of emergency specific nursing mode based on GRACE scoring system in patients with acute coronary syndrome (ACS) during perioperative period. Methods ACS patients (n=265, male 138, female 127 and aged from 39 to 75) were chosen from Sept. 2013 to Mar. 2015, and then divided, according to hospitalized order, into control group (n=132) and observation group (n=133). The control group was given standard specific nursing mode and observation group was given specific nursing mode based on GRACE scoring system. The duration from hospitalization to door-to-balloon (D-to-B), operation period, hospital-stay duration, incidence of operation-related complications and degree scores of satisfaction to nursing were compared between 2 groups. Results The duration from hospitalization to D-to-B [(27.8±13.2) min vs. (45.6±16.4) min], operation period [(42.6±15.5) min vs. (58.7±16.9) min] and hospital-stay duration [(7.8±2.4) d vs. (10.5±2.3) d] were significantly shorter in observation group than those in control group (all P<0.05). The incidence of operation-related complications was significantly lower in observation group than that in control group (10.5% vs. 23.5%, P<0.05). The degree scores of satisfaction to nursing were significantly higher in observation group than those in control group (all P均<0.05). Conclusion The application of GRACE scoring system in stratification nursing for ACS patients can significantly shorten the duration from hospitalization to treatment, reduce incidence of complications and improve nursing quality.