【摘要】 目的 探讨降阶梯思维预检分诊模式在呼吸衰竭患者急救中的应用效果。方法 选取2022年6月至2025年6月到我院就诊的62例呼吸衰竭患者作为研究对象。随机数字表法分为对照组（常规预检分诊模式，31例）和观察组（降阶梯思维预检分诊模式，31例）。比较两组患者的急救效率、肺功能指标、血气指标、临床指标、机械通气相关指标及护理满意度。结果 相较于对照组，观察组患者的预检分诊时间、急救响应时间、首次处置时间、ICU入住时间、机械通气时间、住院时间均明显更短（P<0.001）。干预前，两组患者FEV1、FEV1/FVC、MVV、PaO2、PaCO2水平无明显差异（P>0.05）；干预后7d，两组患者FEV1、FEV1/FVC、MVV、PaO2水平均较干预前升高，PaCO2水平较干预前降低。且相较于对照组，观察组患者FEV1、FEV1/FVC、MVV、PaO2水平明显更高（P<0.05）,PaCO2水平明显更低（P<0.001）。相较于对照组，观察组患者的VAP发生率、再插管率、呼吸机依赖率明显更低（P<0.05），一次性撤机成功率明显更高（P<0.05）。结论 降阶梯思维预检分诊护理模式可显著提高呼吸衰竭患者的急救效率，改善肺功能及血气指标，缩短治疗周期，降低机械通气相关并发症发生率，提高护理满意度，值得临床推广。更多还原

【Abstract】 Objective To explore the application effect of the de-escalation thinking-based triage model in the emergency care of patients with respiratory failure. Methods A total of 62 patients with respiratory failure who visited our hospital from June 2022 to June 2025 were selected as the study subjects. They were randomly divided into a control group(conventional triage model, 31 cases) and an observation group(de-escalation thinking-based triage model, 31 cases) using a random number table. The emergency efficiency, pulmonary function indicators, blood gas parameters, clinical indicators, mechanical ventilation-related indicators, and nursing satisfaction were compared between the two groups. Results Compared with the control group, the observation group showed significantly shorter triage time, emergency response time, first treatment time, ICU stay duration, mechanical ventilation time, and total hospital stay(P < 0.001). Before the intervention, there were no significant differences in FEV1, FEV1/FVC, MVV, PaO2, and PaCO2 between the two groups(P > 0.05); 7 days after the intervention, both groups exhibited increased FEV1, FEV1/FVC, MVV, and PaO2, and decreased PaCO2 compared to pre-intervention levels; moreover, compared with the control group, the observation group had significantly higher levels of FEV1, FEV1/FVC, MVV, and PaO2(P < 0.05), and a significantly lower PaCO2(P < 0.001). Compared with the control group, the observation group had significantly lower incidence rates of VAP, reintubation rate, and ventilator dependence rate(P < 0.05), and a significantly higher success rate of one-time weaning from the ventilator(P < 0.05). Conclusion The de-escalation thinking-based triage nursing model can significantly improve the emergency efficiency of patients with respiratory failure, enhance pulmonary function and blood gas parameters, shorten the treatment cycle, reduce the incidence of complications related to mechanical ventilation, and increase nursing satisfaction. It is worthy of clinical promotion.更多还原