综合性护理在预防急性心肌梗死患者冠脉介入围术期并发交感风暴中的应用

Application of comprehensive nursing intervention in preventing complicated sympathetic storms in patients with acute myocardial infarction by coronary intervention

目的 探讨综合性护理干预在预防急性心肌梗死患者冠脉介入围术期并发交感风暴的应用效果.方法 选取2014年6月～2017年6月在该院行冠脉介入治疗的急性心肌梗死患者101例为研究对象,应用随机数表法分为对照组50例,观察组51例.对照组采用常规围术期护理,观察组在常规护理基础上应用综合性护理干预.分析比较两组患者不同阶段情绪状态改善情况,不良反应以及交感风暴发生情况.结果 入院时,两组患者的消极情绪（SAS、SDS）评分比较,差异无统计学意义（P〉0.05）;对照组在入院时、术前20 min、术后24 h,SAS及SDS均无明显改变,观察组术前20 min及术后24 h SAS、SDS评分均低于对照组,差异有统计学意义（均P〈0.05）.护理后,观察组在围术期血压升高、心率过速、脉搏升高、心绞痛等交感风暴风险事件发生率均低于对照组,差异有统计学意义（均P〈0.05）.围术期观察组的交感风暴发生率低于对照组,差异有统计学意义（P〈0.05）.结论 综合性护理干预在预防急性心肌梗死患者冠脉介入围术期并发交感风暴中应用效果显著,可有效调整患者情绪状态,减少血压、心率波动,降低交感风暴发生率,改善手术预后.

Objective To explore the effect of comprehensive nursing intervention in the prevention of sympa- thetic storms in patients with acute myocardial infarction. Methods A total of 101 cases of patients with acute myocardi- al infarction who underwent coronary intervention in our hospital from June 2014 to June 2017 were selected as the sub- jects of this study. All the patients were divided into control group （n = 50） and observation group （n = 51 ） by random number table method. The control group was treated with routine perioperative care, and the observation group was given comprehensive nursing intervention on the basis of routine nursing. The improvement of mood state, adverse reaction and sympathetic storm were evaluated and compared in different stages between the two groups. Results There was no sig- nificant difference in the scores of negative emotions （ SAS, SDS） between the two groups （P〉 0. 05 ） . SAS and SDS of control group had no significant change during SAS and SDS scores of the observation group were hours after surgery. The difference had statistical hospitalization, 20 minutes before surgery and 24 hours after surgery. lower than those of the control group 20 minutes before surgery and 24 significance （P〈0. 05）. After nursing, the occurrence rate of sympa- thia storm risk events such as elevated blood pressure, tachycardia, pulse elevated and stenocardia of the observation group during perioperative period were lower than those of the control group, and the differences were statistically signif- icant （P〈0. 05 ）. During perioperative period, the incidence of sympathetic storm in the observation group was lower than that in the control group, and the difference was statistically significant （ P〈0. 05 ） . Conclusions Comprehensive nursing intervention has a significant effect on the prevention of coronary intervention in patients with acute myocardial infarction. It can effectively adjust the emotional state of patients, reduce blood pressure and heart rate fluctuation, re- duce the incidence of sympathetic storm, and improve surgical prognosis.