临床护理路径提高冠心病介入手术患者的预后

Prognosis of coronary artery disease patients with percutaneous coronary interven- tion improved by clinical nursing pathways

目的 探究临床护理路径（clinical nursing pathway，CNP）对于施行介入手术的冠心病患者临床预后的提高。方法连续招募2015年3月～2016年5月于该院心内科住院行经皮冠状动脉介入治疗（percuta—neous coronary intervention，PCI）的冠心病患者70例，随机分为两组，两组临床治疗相同，其中35例患者实施临床护理路径为观察组，35例患者实施常规护理模式为对照组。观察两组患者住院时间、住院费用、术后并发症以及治疗后焦虑及抑郁评分和护理满意度，随访PCI术后6个月两组患者主要不良心血管事件（Major adverse eardio．vascular events，MACE）发生隋况。结果两组冠心病患者在基本临床资料如年龄分布、高血压及糖尿病患病率、冠心病病变血管情况等方面比较，差异均无统计学意义（均P〉0．05）。研究发现，与对照组患者相比，临床护理路径组患者住院时间及住院费用显著减少，临床护理满意度显著增高，同时焦虑及抑郁评分均显著下降，术后半年随访发现再发主要不良心血管事件（Major adverse cardiovascular events，MACE）比例显著减少，差异均有统计学意义（均P〈0．05）。此外，临床护理路径组患者PCI术后并发症发生比例有降低趋势。结论实施临床护理路径在冠心病患者介入治疗过程中有积极意义，有利于冠心病患者的预后。

Objective To sis of coronary heart disease patients explore the clinical nursing pathway （CNP） for the improvement of clinical progno- undergoing interventional surgery. Methods From March 2015 to May 2016, 70 patients with coronary heart disease who were admitted to the department of cardiology of the hospital for percutaneous coronary intervention （PCI） were recruited continuously. They were randomly divided into two groups with the same clinical treatment. Among them, 35 patients who implemented the clinical nursing path were set as the observation group, 35 patients who underwent routine nursing were set as the control group. The hospitalization time, hospitaliza- tion expenses, postoperative complications, anxiety, and depression scores and nursing satisfaction of the two groups were observed after treatment. Patients were followed up with major adverse cardiovascular events （MACE） 6 months af- terPCI. Results There was no statistically significant difference between the two groups in basic clinical data, such as age distribution, prevalence of hypertension and diabetes, and coronary artery＇ disease （P〉0. 05）. The study found that, compared with the control group, the length of＇hospital stay and hospitalization expenses of patients in the clinical nursing path group were significantly reduced, the clinical nursing satisfaction was significantly increased, and the anxi- ety and depression scores were significantly reduced, and the proportion of major adverse cardiovascular events （ MACE ） was significantly reduced in the follow-up for six months postoperatively. The differences were statistically sig- nificant （P〈0. 05 ）. In addition, the incidence of complications after PCI in patients in the clinical nursing path group was decreasing. Conclusion The implementation of clinical nursing pathway has positive significance in.the interven- tional therapy of patients with coronary heart disease, which is ＂conducive to the prognosis of patients with coronary heart disease.