智慧化护理方案在急性ST段抬高型心肌梗死患者中的应用研究

doi:10.3761/j.issn.0254-1769.2026.19.008

摘要/Abstract

摘要：

目的探讨基于动态业务流程管理（dynamic business process management，DBPM）的智慧化护理方案对急性ST段抬高型心肌梗死（ST-segment elevation myocardial infarction，STEMI）患者急救护理质量及临床结局的影响，为构建基于信息化平台的STEMI患者急救护理质量改进路径提供参考。方法采用非同期前后对照研究设计，便利选取杭州市某三级甲等医院胸痛中心收治的81例急性STEMI患者作为研究对象。将2025年7—12月收治的38例作为试验组，在常规急救护理基础上实施基于DBPM理论的智慧化护理方案；将2024年10月—2025年3月收治的43例作为对照组，实施常规急救护理流程。比较两组急救护理敏感时效指标、护理救治质量及临床结局。结果两组均无样本脱落。试验组预检分诊—流程启动时间、双联抗血小板治疗负荷给药时间、肌钙蛋白反馈时间、导管室激活时间及入门至导丝通过时间均短于对照组（P<0.05）；试验组经皮冠状动脉介入治疗术后心力衰竭发生率、救治流程中断率均低于对照组，转运交接合格率高于对照组（P<0.05）；试验组住院费用、住院时间均低于对照组（P<0.05）。结论基于DBPM的智慧化护理方案能有效优化STEMI急救护理流程，缩短急救护理敏感时效指标，降低救治流程中断率，提升急救护理执行质量，改善患者临床结局。

关键词: ST段抬高型心肌梗死, 经皮冠状动脉介入治疗, 急诊医疗服务, 工作流程, 临床信息系统, 急症护理

Abstract:

Objective To explore the effects of an intelligent nursing program based on dynamic business process management（DBPM） on the emergency nursing quality and clinical outcomes of patients with acute ST-segment elevation myocardial infarction（STEMI），so as to provide a reference for constructing an emergency nursing quality improvement path for STEMI patients based on an information platform. Methods A non-concurrent pre-post controlled study design was adopted. A total of 81 patients with acute STEMI admitted to the chest pain center of a tertiary grade-A hospital in Hangzhou were conveniently selected as the research subjects. 38 patients admitted from July to December 2025 were assigned to an experimental group，receiving the DBPM-based intelligent nursing program on the basis of conventional emergency nursing. 43 patients admitted from October 2024 to March 2025 were assigned to a control group，receiving the conventional emergency nursing workflow. The emergency nursing-sensitive time indicators，clinical rescue quality，and outcomes were compared between the 2 groups. Results There was no sample loss in either group. The triage-to-process activation time，dual antiplatelet therapy（DAPT） administration time，troponin feedback time，catheterization laboratory activation time，and overall door-to-wire time in the experimental group were significantly shorter than those in the control group（P<0.05）. The incidence of heart failure after percutaneous coronary intervention and the rescue process interruption rate in the experimental group were significantly lower than those in the control group，while the transfer handover compliance rate was significantly higher than that in the control group（P<0.05）. Additionally，the hospitalization cost and length of stay in the experimental group were lower than those in the control group（P<0.05）. Conclusion The intelligent nursing program based on DBPM can effectively optimize the emergency nursing workflow for STEMI patients，shorten key nursing-sensitive time indicators，reduce the process interruption rate，and improve emergency nursing execution quality as well as clinical outcomes.

Key words: ST Elevation Myocardial Infarction, Percutaneous Coronary Intervention, Emergency Medical Services, Workflow, Clinical Information Systems, Emergency Nursing

叶丽霞, 姚慧, 周建萍, 周虹, 计可欣, 李琴. 智慧化护理方案在急性ST段抬高型心肌梗死患者中的应用研究[J]. 中华护理杂志, 2026, 61(19): 2646-2652.

YE Lixia, YAO Hui, ZHOU Jianping, ZHOU Hong, JI Kexin, LI Qin. Application of an intelligent nursing program in patients with acute ST-segment elevation myocardial infarction[J]. Chinese Journal of Nursing, 2026, 61(19): 2646-2652.

图/表 4

表1 基于动态业务流程管理的急性ST段抬高型心肌梗死患者智慧化护理方案

Table 1 Intelligent nursing program for patients with acute ST-segment elevation myocardial infarction based on dynamic business process management

表2 两组一般资料的比较

Table 2 General baseline data of the 2 groups of patients

表3 两组急救护理敏感时效指标的比较（min）

Table 3 Comparison of nursing-sensitive time indicators between the 2 groups（min）

表4 两组救治质量与结局指标的比较

Table 4 Comparison of rescue quality and clinical outcomes between the 2 groups

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