门诊行为干预对PCI术后STEMI病人预后的影响

INFLUENCE OF BEHAVIOR INTERVENTION IN CLINICAL SERVICE ON PROGNOSIS OF PATIENTS WITH STEMI AFTER PCI

目的探讨门诊行为干预对经皮冠状动脉介入治疗(PCI)后急性ST段抬高型心肌梗死(STEMI)病人预后的影响。方法选择行PCI术的STEMI病人160例,随机分为实验组与对照组,各80例。两组病人住院治疗期间均给予个体化的知识教育和行为干预,在此基础上,实验组病人出院后仍进行每月1次门诊行为干预。随访24个月,比较两组病人的主要不良心脏事件发生情况。结果两组病人的全因死亡和非致死性心肌梗死发生率差异无显著意义(P>0.05)。实验组的不稳定型心绞痛和心力衰竭发生率低于对照组(χ2=4.103、4.444,P<0.05),复合心血管不良事件发生率也明显低于对照组(χ2=4.592,P<0.05)。结论实施门诊行为干预措施,帮助病人建立健康的行为方式,可降低PCI术后STEMI病人主要心血管不良事件发生率,改善临床预后。

Objective To investigate the influence of behavior intervention in clinical service on prognosis in patients with post-PCI acute STEMI. Methods A total of 160 post-PCI STEMI patients were evenly randomized to intervention group and control group. All the patients were given individualized knowledge education and behavior intervention. Those in the intervention group still received post-discharge behaviour intervention at outpatient clinic, once a month. The incidence of major adverse cardiac events （MACE） were recorded and compared between the two groups during the 24-month follow-up. Results There was no significant difference in all cause mortality and the incidence of non-fatal myocardial infarction between the two groups （P〉0.05）. Both the incidence of unstable angina and heart failure were lower in the intervention group than that in the control （x^2= 4. 103, 4. 444;P〈0.05）, and the combined incidence rate of MACE was lower as well （Z2 =4. 592 ,P〈0. 05）. Conclusion Practice of clinical intervention can help patients create a healthy life style, reduce MACE in post PCI STEMI and improve their prognosis.