菏泽医学专科学校学报
菏澤醫學專科學校學報
하택의학전과학교학보
JOURNAL OF HEZE MEDICAL COLLEGE
2015年
2期
75-78
,共4页
思维模式%进阶式思维%病情判断%重症监护病房
思維模式%進階式思維%病情判斷%重癥鑑護病房
사유모식%진계식사유%병정판단%중증감호병방
Thinking Model%Advanced thinking%Condition judgment%Intensive Care Unit
目的：探讨进阶式思维（ATCA)判断患者入住ICU的标准的可行性。方法严格筛选入选病历，将患者随机分为3组。一组患者为实验组，采用进阶式思维评估患者，二组患者用APACHEⅡ评估患者，三组患者用APACHEⅢ评估患者。结果经回顾性分析及专家咨询，共18个特征指标进入核心因素思维变量。在三组患者中，精神混乱、呼吸衰竭、电解质紊乱、白细胞计数(WBC)>7.5×109/L、Cr<60μmol/L、腹胀、脉压差≥60 mmHg、焦虑等10个指标实验组发生率低于二组与三组，差异有显著统计学意义（P<0.02)。结论进阶式思维分析可以指导护士建立临床护理思维，改善危重患者不良结局。
目的：探討進階式思維（ATCA)判斷患者入住ICU的標準的可行性。方法嚴格篩選入選病歷，將患者隨機分為3組。一組患者為實驗組，採用進階式思維評估患者，二組患者用APACHEⅡ評估患者，三組患者用APACHEⅢ評估患者。結果經迴顧性分析及專傢咨詢，共18箇特徵指標進入覈心因素思維變量。在三組患者中，精神混亂、呼吸衰竭、電解質紊亂、白細胞計數(WBC)>7.5×109/L、Cr<60μmol/L、腹脹、脈壓差≥60 mmHg、焦慮等10箇指標實驗組髮生率低于二組與三組，差異有顯著統計學意義（P<0.02)。結論進階式思維分析可以指導護士建立臨床護理思維，改善危重患者不良結跼。
목적：탐토진계식사유（ATCA)판단환자입주ICU적표준적가행성。방법엄격사선입선병력，장환자수궤분위3조。일조환자위실험조，채용진계식사유평고환자，이조환자용APACHEⅡ평고환자，삼조환자용APACHEⅢ평고환자。결과경회고성분석급전가자순，공18개특정지표진입핵심인소사유변량。재삼조환자중，정신혼란、호흡쇠갈、전해질문란、백세포계수(WBC)>7.5×109/L、Cr<60μmol/L、복창、맥압차≥60 mmHg、초필등10개지표실험조발생솔저우이조여삼조，차이유현저통계학의의（P<0.02)。결론진계식사유분석가이지도호사건립림상호리사유，개선위중환자불량결국。
Objective To establish a judgment standard of ICU admission according to the main core factors of doctors and nurses (DNCA). Methods Cases were selected strictly and divided into three groups randomly. The first group patiets as 3 experiment group were assessed with the main core factors of doctors and nurses . The second group pa?tients were assessed with APACHEⅢand the thirst group patients with APACHEⅡ. Results We found that 26 factors would cause the complications of ICU significantly. Multiple-factors analysis showed that the mental confusion, respirato?ry failure, electrolyte imbalance, white blood cell count (WBC) > 7.5 × 109/L, Cr < 60 μ mol/L, abdominal distension, pulse pressure difference≥60 mmHg and anxiety can become the main core factors which were there the significant differ?ence statistically (P<0.05). Conclusion The analysis of advanced thinking can help us identify heavy patients quickly, establishment of clinical care and guide the clinical thinking, enhance the practical ability.
