有效护理干预在比伐芦定预防STEMI患者急诊介入术中无复流的疗效

Clinical efficacy of effective nursing intervention in bivalirudin prevention of no reflow in acute ST segment elevation myocardial infarction(STEMI) patients during primary percutaneous coronary intervention

目的探讨有效护理干预在比伐芦定预防STEMI患者急诊介入术中无复流的临床疗效。方法入选我院2012年7月至2015年1月收治的150例急性ST段抬高型心肌梗死患者,随机将患者分为对照组75例,试验组75例。两组患者静脉应用比伐芦定均按标准执行,其中试验组围术期额外给予有效护理干预,而观察组仅给予常规护理。观察两组患者术中无复流、院内出血事件、对护理工作满意度及院外依从性情况。结果试验组患者术末TIMI≤2级0例,而对照组为5例,两组比较差异有统计学意义(P<0.05);同时试验组患者对护理工作的总体满意度(97.4%vs.80.0%,P<0.05)、术后服药情况(96.27%±4.63%vs.73.24%±3.75%,P<0.05)、生活方式改善情况(95.15%±4.12%vs.70.19%±3.67%,P<0.05)、门诊随访情况(93.64%±4.55%vs.75.36%±5.26%,P<0.05)较对照组均明显改善(P<0.05);两组患者均无BARC定义2级以上出血事件发生。结论急性STEMI患者常规给予比伐芦定预防无复流的同时,给予有效护理干预,能够进一步预防术中无复流的发生,并改善患者对护理工作总体满意度及院外依从性情况。

Objective To study the clinical efficacy of effective nursing intervention in bivalirudin prevention of no reflow in acute ST segment elevation myocardial infarction （STEMI） patients during PPCI. Methods Totally 150 cases of STEMI in our hospital from July 2012 to January 2015 were randomly divided into control group and ex- periment group,75 cases in each group. All the patients were given venous bivalirudin according to the standards. Ex- perimental group was given effective nursing intervention, while control group was only given routine nursing. The no refiow, hospital bleeding events, nursing satisfaction and compliance of the two groups were observed. Results There was significant difference in the number of TIMI ≤2 after operation between control group and experimental group （0 vs. 5, P 〈 0. 05 ）. After treatment, the rates of nursing work satisfaction （ 97.4 % vs. 80. 0% ）, postoperative medication compliance （ 96.27% ± 4.63 % vs. 73.24% ± 3.75% ） , lifestyle improvement （ 95.15% ± 4. 12% vs. 70. 19% ± 3.67% ） and the outpatient follow-up （ 93.64% ± 4. 55% vs. 75.36% ± 5.26% ） were higher than those of control group （ P 〈 0. 05 ）. There was no bleeding event defined as above-grade 2 by BARC. Conclusion Effective nursing intervention combined with bivalirudin in acute STEMI patients during PPCI can further prevent no reflow and improve the patient＇s overall satisfaction with nursing work and the compliance.