PCI术后患者自我护理能力与预后的相关性研究

Correlation between self-care capability and prognosis of patients after percutaneous coronary intervention therapy

目的了解经皮冠状动脉介入术(percutaneous coronary intervention,PCI)术后患者自我护理能力现状和术后心血管事件的发生情况,并分析两者的相关性。方法于2016年6—12月,选取上海交通大学附属第一人民医院收治的PCI术后患者120例,采用一般资料调查表、自我护理能力测定量表进行调查,观察患者PCI术后6个月内心血管事件的发生情况,并对患者自我护理能力水平与术后心血管事件发生情况进行相关性分析。结果本研究共发放问卷120份,回收有效问卷110份,随访过程中失访10例,最终纳入分析的患者100例。PCI术后患者自我护理能力处于中等水平;出院后6个月内,自我护理能力低水平组患者总心血管事件发生率高于中/高水平组患者,差异具有统计学意义(P<0.05);PCI术后患者主要心血管事件的危险因素为自我护理能力低水平(OR=10.586,95%CI:1.781～62.936,P<0.05)、有高血脂史(OR=7.529,95%CI:1.278～44.371,P<0.05)、BNP浓度高(OR=1.007,95%CI:1.003～1.011,P<0.05),且自我护理能力低水平组PCI患者心血管事件发生是中/高水平组患者的10.6倍。结论患者自我护理能力差是PCI术后心血管事件发生的主要危险因素,医护人员应加大对患者自我护理能力的重视程度,增强患者的自我护理责任感,提高其自我护理技能及健康知识水平,从而降低患者PCI术后心血管事件的发生率。

Objective To evaluate the correlation between self-care capability and prognosis of the patients after percutaneous coronary intervention(PCI)therapy.Methods Totally 120 patients after PCI therapy in Shanghai General Hospital,Shanghai Jiao Tong University were selected from June to December 2016.According to the scores of the Exercise of Self-Care Agency Scale(ESCA),the patients were divided into low-level group and middle/high-level group.The incidence of major adverse cardiac events(MACEs)in 6 months after discharge was compared between the two groups.Results The self-care capability of the patients after PCI therapy was in the middle level.The overall incidence of MACEs in the low-level group was higher than that in the middle/high-level group(P<0.05).The incidence of MACEs after PCI therapy was related to self-care capability,hyperlipemia history,and high B-type natriuretic peptide(BNP)level(P<0.05).Conclusion Poor patients’self-care capability was the major influencing factor of MACEs after PCI therapy.The nursing staff should pay attention to this and strengthen patients’self-care capability to decrease the incidence of MACEs.