急性缺血性卒中患者静脉溶栓决策辅助手册的编制及应用研究

doi:10.3761/j.issn.2096-7446.2023.05.001

摘要/Abstract

摘要： 目的探讨决策辅助手册在急性缺血性卒中患者静脉溶栓知情同意中的应用效果。方法便利选取2019年6月—2021年5月安徽省某三级甲等医院收治的189例急性缺血性卒中患者为研究对象,按照入院时间分组,试验组118例（2020年6月—2021年5月）采用以决策辅助手册为基础的知情同意方式,对照组71例（2019年6月—2020年5月）采用传统的知情同意方式。比较两组入院至家属签署知情同意书时间、神经内科医生接诊至签署知情同意书时间、入院至静脉溶栓治疗时间（door-to-needle time,DNT）、DNT≤45 min达标率的差异。结果试验组入院至签署知情同意书时间、神经内科医生接诊至签署知情同意书时间、DNT时间、DNT≤45 min达标率均优于对照组,差异具有统计学意义（P<0.001）。结论在急性缺血性卒中患者静脉溶栓知情同意中应用决策辅助手册,缩短了获取患方知情同意的时间以及DNT时间,提高了急性缺血性卒中患者救治的及时性。

关键词: 缺血性卒中, 决策辅助手册, 血栓溶解疗法, 知情同意, 急症护理

Abstract: Objective To investigate the effect of decision aid manual in obtaining informed consent for intravenous thrombolysis in patients with acute ischemic stroke. Methods Patients with acute ischemic stroke who received intravenous thrombolysis in a tertiary class A hospital in Anhui Province from June 2019 to May 2021 were selected as study subjects by convenient sampling. They were divided into two groups according to admission time. 118 patients in the experimental group（June 2020 to May 2021）received informed consentmethod based on the decision-aid manual. 71 patients in the control group（June 2019 to May 2020）received the traditional informed consent method. The time from admission to signing the informed consent form by the family,the time from the visit of neurologist to signing the informed consent form,door-to-needle time（DNT）,and the achievement rate of DNT≤45 min were compared between the two groups. Results The time from admission to signing informed consent,time from neurologist's visit to signing informed consent,time from door to needle,and DNT≤45 min attainment rate in the experimental group were better than those in the control group, and the differences were statistically significant（P<0.001）. Conclusion The application of the decision aid manual in the informed consent conversation for intravenous thrombolysis in acute ischemic stroke patients shortened the time to obtain informed consent from the patient and the DNT time,and improved the timeliness of treatment for acute ischemic stroke patients.

Key words: Ischemic Stroke, Decision Aid Manual, Thrombolytic Therapy, Informed Consent, Emergency Nursing

姚婷, 窦敏, 张理想, 马汉. 急性缺血性卒中患者静脉溶栓决策辅助手册的编制及应用研究[J]. 中华急危重症护理杂志, 2023, 4(5): 389-393.

YAO Ting, DOU Min, ZHANG Lixiang, MA Han. Development and application of a decision support manual for intravenous thrombolysis in patients with acute ischemic stroke[J]. Chinese Journal of Emergency and Critical Care Nursing, 2023, 4(5): 389-393.

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