延续性护理对下肢动脉硬化闭塞症患者介入术后运动功能、 预后的影响

Effect of continuous nursing on motor function and prognosis of patients with arteriosclerosis obliterans in lower extremity

目的:探讨延续性护理对下肢动脉硬化闭塞症患者介入术后运动功能、预后的影响并对相关因素进行分析。方法:选取于江苏大学附属武进医院行介入治疗的下肢动脉硬化闭塞症患者82例,随机分为对照组和干预组,每组各41例。对照组在出院时给予常规护理,干预组在对照组护理基础上,给予延续性护理。随访12个月,记录患者血管再狭窄的时间。比较两组出院12个月时的运动功能。应用Cox比例风险模型分析影响患者术后血管再狭窄的危险因素。应用Kaplan-Meier法绘制预后时间曲线,采用Log-rank检验比较患者的预后。结果:干预组在出院12个月时的运动功能显著优于对照组患者(P<0.001);在出院3,6,12个月时,干预组血管再狭窄率均低于对照组(5.37%vs19.51%,12.20%vs31.71%,17.07%vs39.02%),差异均有统计学意义(P<0.05)。干预组预后明显优于对照组(χ2=5.625,P=0.018)。单因素及多因素回归分析显示:延续性护理是防止下肢动脉硬化闭塞症患者介入术后再狭窄的有利因素(P<0.001)。结论:延续性护理可有效改善下肢动脉硬化闭塞症患者介入术后的运动功能及预后,是防止下肢动脉硬化闭塞症患者介入术后再狭窄的有利因素。

Objective： To explore the effect of continuous nursing on the motor function and prognosis of patients with arteriosclerosis obliterans in lower extremity and to analyze the related factors. Methods： Eighty-two patients with arteriosclerosis obliterans who underwent interventional therapy in this hospital were randomly divided into a control group and an intervention group, 41 cases in each group. Patients in the control group were given routine care at the time of discharge. Patients in the intervention group were given continuous care on the basis of the control group. Patients were followed for 12 months and the time of restenosis was recorded. The motor function was compared between the two groups at 12 months after discharge. Cox proportional hazards model was used to analyze the risk factors for postoperative vascular restenosis. Kaplan-Meier method was used to draw the prognostic time curve, and Log-rank test was used to compare the prognosis of the patients. Results： The exercise ability of patients in the intervention group at the 12 th month after discharge was significantly better than that in the control group（P〈0.001）; at 3, 6, and 12 months after discharge, the rate of restenosis in the intervention group was lower than that in the control group（5.37% vs 19.51%, 12.20% vs 31.71%, 17.07% vs 39.02%）, the difference was statistically significant（P〈0.05）. The prognosis of the intervention group was significantly better than that of the control group（χ2=5.625, P=0.018）. Univariate and multivariate regression analysis showed that continuation nursing was a favorable factor to prevent restenosis after interventional intervention in patients with arteriosclerosis obliterans in the lower extremity（P〈0.001）. Conclusion： Continuous nursing can effectively improve the motor function and prognosis of patients with arteriosclerosis obliterans in lower extremity after interventional intervention. It is a favorable factor to prevent restenosis after interventional treatment of patients with arteriosclerosis obliterans in lower extremities.