循证模式的护理干预措施对急性冠脉综合征病人的护理效果分析以及方法指导.docx

循证模式的护理干预措施对急性冠脉综合征病人的护理效果分析以及方法指导 中文摘要：ACS是一种常见的严重的心血管疾病，是冠心病的一种严重类型。常见于老年、男性及绝经后女性、吸烟、高血压、糖尿病、高脂血症、腹型肥胖及有早发冠心病家族史的患者。ACS患者常常表现为发作性胸痛、胸闷等症状，可导致心律失常、心力衰竭、甚至猝死，严重影响患者的生活质量和寿命。如及时采取恰当的治疗方式，则可大大降低病死率，并减少并发症，改善患者的预后。循证护理是护理人员在计划护理活动过程中，审慎地、明确地、明智地将科研结论与临床经验、患者愿望相结合，获取证据，作为临床护理决策依据的过程。也是循证医学和循证保健必不可少的环节。本文对一例采用循证模式的护理干预进行个案分析，以期为该类疾病的循证护理提供方法指导。 English Abstract：ACS is a common and serious cardiovascular disease and a serious type of coronary heart disease. Common in elderly, male and postmenopausal women, smoking, hypertension, diabetes, hyperlipidemia, abdominal obesity and patients with a family history of early onset coronary heart disease. Patients with ACS often present with symptoms such as paroxysmal chest pain and chest tightness, which can lead to arrhythmia, heart failure, and even sudden death, which seriously affect the quality of life and longevity of patients. If appropriate treatment is taken in time, the mortality rate can be greatly reduced, complications can be reduced, and the prognosis of patients can be improved. Evidence-based nursing is a process in which caregivers carefully, clearly and wisely combine scientific research conclusions with clinical experience and patient wishes in the process of planning nursing activities to obtain evidence as a basis for clinical nursing decision-making. It is also an essential part of evidence-based medicine and evidence-based health care. This article analyzes a case-by-case model of nursing interventions to provide evidence-based guidance for evidence-based care for such diseases. Key words: evidence-based nursing; acute coronary syndrome; nursing effect analysis; method guidance 患者资料 1.基本资料 患者黄仁清，男，51岁，于早晨7点左右无明显诱因突发胸闷，位于胸骨后，持续性胸闷、隐痛，伴出汗，恶心。患者至第九人民医院就诊，查心电图提示：v2-v4ST段抬高，心肌酶示：CKMB 36.1ng/ml MWO 528.6ng/ml，当时未予特殊诊疗。患者胸闷仍持续不缓解，并伴有肩背部疼痛，遂于下午至我院急诊就诊，急诊心电图提示：v3-v4ST段抬高，心肌酶示：TnI 7.7ng/ml CKMB 344ng/ml MYO 900ng/ml，急诊考虑“急性冠脉综合征”，于阿司匹林、替格瑞洛、瑞舒伐他汀等药物对症处理后，患者诉症状逐渐较前好转，现为进一步治疗，于2018-09-18 18:41:45收住我科。 2.既往病史 体质健康，否