ISSN 2097-6046（网络）
ISSN 2096-7446（印刷）
CN 10-1655/R
主管：中国科学技术协会
主办：中华护理学会
中华急危重症护理杂志

中华急危重症护理杂志 ›› 2026, Vol. 7 ›› Issue (8): 986-992.doi: 10.3761/j.issn.2096-7446.2026.08.017

• 质量与安全 • 上一篇    下一篇

导管室护士对心肌梗死患者介入术中病情恶化识别与应对体验的质性研究

佘莉萍1(), 王晋举1, 吴亚峰1, 李绍满1, 郑雪梅2,*()   

  1. 1 南京医科大学附属南京医院/南京市第一医院心血管内科导管室 南京市 210001
    2 南京医科大学附属南京医院/南京市第一医院心血管内科 南京市 210001
  • 收稿日期:2025-10-09 出版日期:2026-08-10 发布日期:2026-08-04
  • 通讯作者: *郑雪梅，E-mail：xmzheng@163.com
  • 作者简介:佘莉萍：女，本科，副主任护师，E-mail：sheliping80@163.com
    作者贡献声明

    佘莉萍：研究设计与实施、论文撰写；王晋举：资料收集与分析、论文撰写；吴亚峰：资料收集与分析；李绍满：论文修改；郑雪梅：论文修改、方法学指导、经费支持

A qualitative study on catheterizatio n laboratory nurses in recognizing and responding to clinical deterioration during percutaneous coronary intervention in patients with myocardial infarction

SHE Liping1(), WANG Jinju1, WU Yafeng1, Li Shaoman1, ZHENG Xuemei2,*()   

  1. 1 Department of Cardiology， Catheterization Laboratory，Nanjing First Hospital/Nanjing Medical University Nanjing Hospital， Nanjing 210001， China
    2 Department of Cardiology， Nanjing First Hospital/Nanjing Medical University Nanjing Hospital， Nanjing 210001， China
  • Received:2025-10-09 Online:2026-08-10 Published:2026-08-04
  • Contact: *ZHENG Xuemei，E-mail：xmzheng@163.com

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摘要：

目的 探讨导管室护士在ST段抬高型心肌梗死患者急诊经皮冠状动脉介入术中病情恶化的识别与应对体验，为优化护士的临床判断、提升患者救治成功率提供参考。 方法 以Tanner临床判断模型为理论基础，采用现象学研究方法，于2025年1月—2月对南京市某三级甲等医院13名导管室护士进行半结构化访谈，运用Colaizzi 7步分析法对访谈资料进行分析。 结果 共提炼6个主题及8个子主题：病情观察（客观指标的直观性，症状体征的预测性），重视经验（相信直觉，融合知识），整合信息（临床推理，排除干扰），确定优先级，凝聚团队（合作与协调，执行与审视），反思成长。 结论 导管室护士在ST段抬高型心肌梗死患者急诊经皮冠状动脉介入术中对病情恶化的识别与应对是理论、直觉、快速决策与团队协作高度融合的动态过程。护理管理者应构建兼顾客观指标与非量化指标的培训体系，推动护士经验转化，通过明确医护权责分工、优化协作决策流程及强化反思机制，全面提升护士的临床判断能力，保障患者安全。

关键词: 介入导管室, 护士, ST段抬高型心肌梗死, 经皮冠状动脉介入治疗, 质性研究

Abstract:

Objective To explore the experiences of catheterization laboratory nurses in recognizing and respond-ing to clinical deterioration during emergency percutaneous coronary intervention in patients with ST-segment eleva-tion myocardial infarction，providing evidence for optimizing nurses’ clinical judgment and improving patient out-comes. Methods Guided by Tanner’s Clinical Judgment Model，a phenomenological approach was used. Semi-structured interviews were conducted with thirteen catheterization laboratory nurses in a tertiary hospital in Nanjing，China，from January to February 2025. Interview data were analyzed using Colaizzi’s seven-step method. Results Six themes and eight subthemes were identified：patient observation（including the salience of objective indicators and the predictive value of symptoms and signs）；valuing experience（trusting intuition and integrating knowledge）；information synthesis（clinical reasoning and filtering interference）；prioritization of interventions；team cohesion （collaboration and coordination，execution and review）；and reflective growth. Conclusion The identification and responding of clinical deterioration by catheterization laboratory nurses during emergency percutaneous coronary intervention constitute a dynamic process characterized by the close integration of theoretical knowledge，intuitive judgment，rapid decision-making，and team collaboration. Nursing managers should establish training systems that integrate objective indicators with non-quantifiable cues，promote the transformation of nurses’ experiential knowledge，and enhance clinical judgment capacity through clearly defined interprofessional roles and responsibilities，optimized collaborative deci-sion-making processes and reflective mechanisms，comprehensively enhanced nurses’ clinical judgment abilities，thereby ensuring patient safety.

Key words: Catheterization Laboratory, Nurse, ST-Segment Elevation Myocardial Infarction, Pe-rcutaneous Coronary Intervention, Qualitative Study