老年综合评估护理模式对老年冠心病患者不良事件的影响

Influence of comprehensive geriatric assessment nursing mode on adverse events in elderly patients with coronary heart disease

目的探讨老年综合评估(CGA)护理模式对老年冠心病患者心脏和护理不良事件的影响。方法选取陆军总医院干四科住院老年冠心病患者78例,随机分成干预组(n=40)和对照组(n=38),对照组给予心内科护理常规,干预组在此基础上实施CGA护理模式进行干预,3个月后对比两组患者心脏不良事件(顽固性心绞痛、急性心肌梗死、心律失常、心源性休克、心力衰竭、猝死)及护理不良事件(压疮、坠床、跌倒、烫伤、误吸窒息、拔管等)发生率。结果干预组和对照组在年龄、性别、病程、伴随基础疾病、服药史方面比较差异无统计学意义(P>0.05)。经过3个月的干预后,干预组心脏不良事件发生率明显低于对照组(7.5%vs.50.0%,P<0.05),干预组护理不良事件发生率明显低于对照组(5.00%vs.44.74%,P<0.05)。结论 CGA护理模式能减少老年冠心病患者心脏和护理不良事件发生率,提高患者生活质量。

Objective To investigate the influence of comprehensive geriatric assessment（CGA） nursing mode on cardiac and nursing adverse events in elderly patients with coronary heart disease（CHD）. Methods The elderly patients with CHD（n=78） were chosen from the Department of Fourth Cadre Ward of Chinese PLA Army General Hospital, and randomly divided into intervention group（n=40） and control group（n=38）. The control group was given routine nursing and intervention group was additionally given the intervention of CGA nursing mode. The incidence of cardiac adverse events（refractory angina pectoris, acute myocardial infarction, arrhythmia, cardiogenic shock, heart failure and sudden death） and nursing events（pressure sore, falling out of bed, fall, empyrosis, aspiration, suffocation, extubation and miss-medication） were observed in 2 groups after 3 m. ResultsThe differences in age, sex, disease course, accompanied basic diseases and medication history had no statistical significance between 2 groups（P〉0.05）. After intervention for 3 m, the incidence of cardiac adverse events was significantly lower in intervention group than that in control group（7.5% vs. 50.0%, P〈0.05）, and incidence of nursing adverse events was significantly lower in intervention group than that in control group（5.00% vs. 44.74%, P〈0.05）. Conclusion CGA nursing mode can reduce the incidence of cardiac and nursing adverse events and improve quality of life in elderly patients with CHD.