整体护理对急性心肌梗死患者PCI术后治疗依从性和预后的影响

The effect of holistic nursing on the treatment compliance and prognosis of acute myocardial infarction patients after PCI

目的 探讨整体护理对急性心肌梗死患者PCI术后治疗依从性和预后的影响.方法 选取该院收治的急性心肌梗死患者86例,随机分为常规组与观察组,各43例.两组患者均给予PCI术治疗,术后给予早期康复干预,观察组患者联合整体护理,比较两组患者出院时、出院1个月、3个月、出院1年抗血小板治疗依从性、心功能情况,统计两组患者出院1年内发生的心脏不良事件,评估再狭窄发生率.结果 出院1年时,观察组患者LVEF显著高于常规组患者,但两组LVEDd、PWT差异无统计学意义;观察组患者出院1个月时的服药依从性与常规组患者比较差异无统计学意义,但观察组患者出院3个月、出院1年时依从性评分,均显著高于常规组患者,差异均有统计学意义（均P〈0.05）;常规组患者心脏不良事件总发生率（27.9% ）显著高于观察组患者（4.3% ）,差异有统计学意义（P〈0.05）;干预后观察组患者体力状况、病情、一般生活评分均显著高于常规组患者,差异均有统计学意义（均P〈0.05） ;术后随访1年,常规组患者再发生急性心肌梗死、支架内血栓形成与观察组患者比较,差异无统计学意义.结论 早期康复干预联合整体护理可提高急性心肌梗死患者PCI术后抗血小板治疗依从性,并减少心脏不良事件发生,降低心肌梗死再发生率,改善患者预后,值得推广应用.

Objective To explore the effect of holistic nursing on the treatment compliance and prognosis of a-cute myocardial infarction patients after PCI. Methods A total of 86 cases of patients with acute myocardial infarction treated in cardiothoracic surgery department in this hospital were selected. According to the random number table meth-od, they were divided into the routine group and the observation group, 43 cases of each group. Patients in both groups were treated with PCI and received early rehabilitation intervention after surgery. The observation group was combined with holistic nursing. The patients of the two groups were compared at the time of discharge, 1 month, 3 months after discharge, 1 year after discharge for anti-platelet therapy compliance and cardiac function. The incidence of restenosis was assessed by statistical analysis of cardiac adverse events that occurred within 1 year of discharge. Results At 1 year after discharge, LVEF in the observation group was significantly higher than that in the conventional group, but there was no statistically significant difference in LVEDd and PWT between the two groups. There was no significant difference in medication compliance between the observation group and the routine group at 1 month after discharge. However, compliance scores of the observation group were significantly higher than those of the conventional group at 3 months after discharge and 1 year after discharge, with statistically significant differences （ P〈0.05） . The total inci-dence of cardiac adverse events was significantly higher in the routine group （27.9% ） than in the observation group （4.3%）, and the difference was statistically significant （P〈0.05）. After the intervention, the physical condition, condition and general life scores of the observation group were significantly higher than those of the conventional group, with statistically significant differences （ P〈0.05） . After 1 year of postoperative follow-up, there was no statistically significant difference between patients in the conventional group who had suffered from acute myocardial infarction, thrombosis in the stent, and patients in the observation group. Conclusions Early rehabilitation intervention combined with holistic nursing can improve the compliance of antiplatelet therapy after PCI in patients with acute myocardial infarc-tion, reduce the incidence of cardiac adverse events, reduce the recurrence rate of myocardial infarction, and improve the prognosis of patients, which is worthy of popularization and application.