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目的：探讨急诊分层管理配合介入治疗对急性下肢动脉血栓患者的临床效果，为临床护理工作提供可借鉴的方法。方法：回顾性分析2010 年9 月-2013 年11 月在我院接受治疗的69 例急性下肢动脉血栓患者的临床资料。所有患者均接受手术溶栓治疗，术后将患者随机分为两组。常规护理组患者采用基本护理模式，而分层管理组患者采用层级管理的护理模式。观察并比较两组患者术后并发症的发生率及对护理服务的满意度等。结果：分层管理组患者患肢复通率为91.28%；常规护理组患者患肢复通率为84.61%；两组患者治疗后的患肢与健肢周径差均明显小于本组溶栓前的对应值，组内比较差异具有统计学意义(P<0.05)，组间比较差异无显著性(P>0.05)。分层管理组护理工作的落实率为95.68%，患者治疗的依从性为93.91%，对护理人员服务态度的满意度为94.56%，对护理技能的满意度为93.78%，对健康指导的满意度为95.46%，对护患沟通的满意度为97.76%；常规护理组护理工作的落实率为76.55%，患者治疗的依从性为67.82%，对护理人员服务态度的满意度为89.66%，对护理技能的满意度为 86.32%，对健康指导的满意度为85.47%，对护患沟通的满意度为86.21%。分层管理组的护理质量、工作落实率、患者依从性及满意度显著高于常规护理组，差异具有统计学意义(P<0.05)。结论：分层管理的护理模式对急性下肢动脉血栓患者的治疗与预后起着重要的作用，值得临床推广。

英文摘要:

Objective:To discuss the clinical effects of the hierarchical nursing management on the treatment of the acute lower limbs artery thrombosis in order to make a reference for the clinical nursing work on the department of outpatient.Methods:A retrospective analysis was performed about the clinical data of 69 patients with the acute lower limbs artery thrombosis who were treated in our hospital between September 2010 and November 2013. All the patients accepted the thrombolysis surgery and were randomly divided into two groups. The patients in the control group were treated by the conventional nursing method, while the patients in the study group were treated by the hierarchical nursing management. Then the clinical effects of patients and the satisfaction of nursing service were observed and compared between two groups.Results:The rate of dissolution was 91.28% in the hierarchical nursing management group and 84.61% in the control group, better than before with statistically significant differences in each group(P<0.05). There was no statistically significant difference between two groups (P>0.05). In the hierarchical nursing management group, the rate of nursing commitment was 95.68%, the compliance of patients was 93.91%, the satisfaction of the nursing attitude, the nursing skills, the health guidance and the communication between nurses and patients was 94.56%, 93.78%, 95.46% and 97.76%, respectively. In the control group, the rate of nursing commitment was 76.55%, the compliance of patients was 67.82%, the satisfaction of the nursing attitude, the nursing skills, the health guidance and the communication between nurses and patients was 89.66%, 86.32%, 85.47% and 86.21%, respectively. The nursing quality, the rate of commitment, the patients’compliance and the satisfaction of nursing work in the hierarchical group were better than those of the control group with statistically significant differences(P<0.05).Conclusion:It is suggested that the hierarchical nursing management should be promoted to improve the clinical effects of patients with the acute lower climbs thrombosis.

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