Abstract:

Objective　To explore the application of multidisciplinary collaborative tiered emergency nursing care in patients with cardiac arrest caused by arrhythmias. Methods　A prospective study design was used. Ninety-six patients with cardiac arrest caused by arrhythmias treated at Xi'an Hospital of Traditional Chinese Medicine from January 2021 to December 2022 were selected. The patients were divided into a control group and an experimental group according to the time of admission, with 48 patients in each group. The control group included 24 males and 24 females; they were (58.35±7.78) years old; primary diseases: there were 20 cases of coronary heart disease, 10 cases of myocarditis, 8 cases of hypertensive heart disease, 6 cases of valvular heart disease, and 4 cases of myocardial infarction. The experimental group included 23 males and 25 females; they were (58.47±7.82) years old; primary diseases: there were 21 cases of coronary heart disease, 9 cases of myocarditis, 9 cases of hypertensive heart disease, 5 cases of valvular heart disease, and 4 cases of myocardial infarction. The control group received conventional emergency nursing care, while the experimental group received multidisciplinary collaborative tiered emergency nursing care. Both groups were intervened until the patients were discharged. The recovery times of vital signs (spontaneous breathing, sinus rhythm, and autonomous circulation), rescue success rates, hospital stays, and scores of Glasgow Coma Scale (GCS), Simplified Chinese version of Depression-Anxiety-Stress Scale-21 (DASS-21), and General Quality of Life Inventory-74 (GQOLI-74) were compared between the two groups. t and χ² tests were applied. Results　The recovery times for spontaneous breathing, sinus rhythm, and autonomous circulation in the experimental group were shorter than those in the control group [(56.27±16.48) h vs. (108.67±27.84) h, (2.24±0.69) d vs. (5.68±1.34) d, and (42.87±13.68) h vs. (129.56±36.37) h], with statistical differences (t=11.22, 15.81, and 15.46; all P<0.05). The rescue success rate and score of GCS after the intervention in the experimental group were higher than those in the control group [93.75% (45/48) vs. 79.17% (38/48) and (7.74±0.91) vs. (5.37±0.76)]; the hospital stay in the experimental group was shorter than that in the control group [(10.96±2.13) d vs. (15.68±3.24) d]; there were statistical differences (χ²=4.36; t=13.85 and 8.43; all P<0.05). The scores of stress, depression, and anxiety after the intervention in the experimental group were lower than those in the control group [(6.86±1.21) vs. (9.37±1.34), (4.57±1.27) vs. (6.15±1.37), and (6.38±1.67) vs. (9.57±2.16)], with statistical differences (t=9.63, 5.86, and 8.10; all P<0.05). The scores of physical function, social function, material living conditions, and psychological function after intervention in the experimental group were higher than those in the control group, with statistical differences (t=11.40, 11.52, 9.76, and 8.93; all P<0.05). Conclusion　Multidisciplinary collaborative tiered emergency nursing care for patients with cardiac arrest caused by arrhythmias can significantly improve the rescue success rate, shorten the recovery times of vital signs, reduce hospital stay, alleviate their negative emotions, improve their GCS scores and quality of life, and provide effective practical guidance for the emergency nursing care for patients with cardiac arrest caused by arrhythmias.

Key words:

Arrhythmias, Cardiac arrest, Multidisciplinary collaborative tiered, Emergency nursing care, Vital signs

摘要：

目的　探究多学科协作分层急救护理对心律失常致心搏骤停患者的应用。方法　采用前瞻性研究设计，选取2021年1月至2022年12月西安市中医医院收治的96例心律失常导致心搏骤停的患者。按照收治时间将患者分为两组，每组48例。对照组中男24例，女24例；年龄45～70（58.35±7.78）岁；原发病：冠心病20例，心肌炎10例，高血压性心脏病8例，瓣膜性心脏病6例，心肌梗塞4例。试验组中男23例，女25例；年龄46～69（58.47±7.82）岁；原发病：冠心病21例，心肌炎9例，高血压性心脏病9例，瓣膜性心脏病5例，心肌梗塞4例。对照组接受常规急救护理，试验组采用多学科协作分层急救护理。两组均干预至患者出院。比较两组生命体征恢复时间（自主呼吸、窦性心律、自主循环）、抢救成功率、住院时间、格拉斯哥昏迷指数表（GCS）评分、抑郁－焦虑－压力量表简体中文版（DASS-21）评分和生活质量综合问卷（GQOLI-74）评分。统计学方法采用t检验、χ²检验。结果　试验组的自主呼吸、窦性心律和自主循环等恢复时间均短于对照组［（56.27±16.48）h比（108.67±27.84）h、（2.24±0.69）d比（5.68±1.34）d、（42.87±13.68）h比（129.56±36.37）h］，差异均有统计学意义（t=11.22、15.81、15.46，均P<0.05）；试验组的抢救成功率、干预后GCS评分均高于对照组［93.75%（45/48）比79.17%（38/48）、（7.74±0.91）分比（5.37±0.76）分］，住院时间短于对照组［（10.96±2.13）d比（15.68±3.24）d］，差异均有统计学意义（χ²=4.36，t=13.85、8.43，均P<0.05）；试验组干预后的压力、抑郁和焦虑评分均低于对照组［（6.86±1.21）分比（9.37±1.34）分、（4.57±1.27）分比（6.15±1.37）分、（6.38±1.67）分比（9.57±2.16）分］，差异均有统计学意义（t=9.63、5.86、8.10，均P<0.05）；试验组干预后的躯体功能、社会功能、物质生活状态和心理功能等评分均高于对照组，差异均有统计学意义（t=11.40、11.52、9.76、8.93，均P<0.05）。结论　多学科协作分层急救护理能提高心律失常导致心搏骤停患者的抢救成功率，尽快恢复生命体征，缩短住院时间，减轻消极情绪，提高GCS评分和生活质量，为心律失常致心搏骤停患者的急救护理提供有效的实践指导。

关键词:

心律失常, 心搏骤停, 多学科协作分层, 急救护理, 生命体征