冠心病介入治疗术后连续性护理的实施效果评价

Evaluation of the implementation effect of continuous nursing care in patients after percutaneous coronary intervention

目的 研究对冠心病介入治疗术后患者实施连续性护理的意义.方法 将入选的200例冠心病介入治疗患者,利用信封法分成对照组和试验组各100例.对照组实施介入术后常规护理,试验组在对照组的基础上实施连续性护理.比较2组患者服药依从性、心脏主要不良事件（MACE）发生率、患者满意度以及支架内再狭窄发生率.结果 试验组与对照组从6个月开始服药依从性出现差异,根据Morisky测量表,试验组和对照组干预后6个月得分分别为（8.00±0.00）、（7.66±0.82）分,12个月得分分别为（7.94±0.48）、（7.28±1.58）分,2组比较差异有统计学意义（t=-4.086、-3.899,均P〈0.01）;试验组与对照组MACE发生率分别为1%（1/100）、4%（4/100）;试验组与对照组患者满意度分别为98%（98/100）、81%（81/100）,2组比较差异有统计学意义（χ2=36.39,P〈0.01）;试验组与对照组介入术后12个月复查冠状动脉造影,支架内再狭窄发生率分别为1.2%（1/82）、2.5%（2/79）,2组比较差异无统计学意义（χ2=0.392,P=0.613）.结论 对冠心病介入治疗术后患者实施连续性护理能明显提高患者服药依从性,减少MACE事件的发生,提高患者对护理服务的满意度.

Objective To evaluate the implementation effect of continuous nursing care in patients after percutaneous coronary intervention. Methods Totally 200 patients underwent coronary intervention were equally divided into the control group and the experimental group. Randomization was done by sealed envelopes. Routine nursing was applied inthe control group while the patients inthe experimental group werenursed continuously. Compliance of taking medication, the incidence of major adverse cardiac events （MACE events）, satisfactory rate of the patients and the occurrence of stent restenosis were compared between the two groups. Results There was a significant difference between the experimental group and the control group in compliance of taking medication from the 6th month. According to the Morisky measurement, the score of the 6th month in the experimental group was 8.00 ± 0.00, while the control group was 7.66 ± 0.82. There was a statistical significance between the two groups （t=-4.086, P〈0.01）; the score of the 12th month in the experimental group was 7.94 ± 0.48, and for the control group, the score was 7.28 ± 1.58, the difference was statistically significant （t=-3.899, P〈0.01）. The major adverse cardiac events （MACE events） were 1% （1/100） and 4%（4/100） for the experimental and control group respectively. The satisfactory rate of the patients in the experimental group and the control group were 98%（98/100） and 81%（81/100） separately. The difference between the two groups was of statistical significance （χ2=36.39, P〈0.01）. The restenosis rate of the two groups was 1.2% （1/82） and 2.5% （2/79） separately, which was of no significance （χ^2=0.392, P=0.613）. Conclusions Continuous nursing can significantly improve the patients′ medication compliance, reduce the occurrence of MACE events, and improve the satisfaction of nursing care.