身心综合护理对急性心肌梗死并左心衰竭患者经皮冠状动脉介入治疗后负性情绪及心功能的影响

Impact of Psychosomatic Comprehensive Nursing Care on Negative Emotion and Cardiac Function in Postoperative Acute Myocardial Infarction Patients Complicated with Left Heart Failure Treated by PCI

目的探讨身心综合护理对急性心肌梗死(AMI)并左心衰竭患者经皮冠状动脉介入治疗(PCI)后负性情绪及心功能的影响。方法选取2017年1月-2018年5月在淮安市第二人民医院行PCI的AMI并左心衰竭患者60例,采用随机数字表法分为对照组和研究组,每组30例。对照组患者给予冠心病重症监护室(CCU)常规护理,研究组患者在对照组基础上给予身心综合护理(包括心理护理和心脏康复运动);两组患者均连续干预5 d。比较两组患者PCI后第1天、第5天焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分,PCI前及PCI后第5天左心室射血分数(LVEF)、左心室舒张末期容积(LVEDV)及PCI后第5天6分钟步行距离(6MWD),并观察干预期间两组患者不良心血管事件发生情况。结果(1)PCI后第1天两组患者SAS、SDS评分比较,差异无统计学意义(P>0.05);PCI后第5天研究组患者SAS评分、SDS评分低于对照组(P<0.05)。(2)PCI前两组患者LVEF、LVEDV及PCI后第5天LVEDV比较,差异无统计学意义(P>0.05);PCI后第5天研究组患者LVEF高于对照组,6MWD长于对照组(P<0.05)。(3)两组患者干预期间不良心血管事件发生率比较,差异无统计学意义(P>0.05)。结论身心综合护理可有效改善AMI并左心衰竭患者PCI后负性情绪及心功能。

Objective To investigate the impact of psychosomatic comprehensive nursing care on negative emotion and cardiac function in postoperative acute myocardial infarction(AMI)patients complicated with left heart failure treated by PCI. Methods A total of 60 postoperative AMI patients complicated with left heart failure treated by PCI were selected in the Second People’s Hospital of Huai’an from January 2017 to May 2018,and they were divided into control group and study group according to random number table method,with 30 cases in each group. Patients in control group received routine CCU nursing care,while patients in study group received psychosomatic comprehensive nursing care(including psychological nursing care and cardiac rehabilitation exercise)based on that of control group;both groups continuously intervened for 5 days. SAS score and SDS score 1 day and 5 days after PCI,LVEF and LVEDV before PCI and 5 days after PCI,and 6-minute walking distance5 days after PCI were compared between the two groups,and incidence of adverse cardiovascular events was observed during intervention. Results(1)No statistically significant difference of SAS score or SDS score was found between the two groups1 day after PCI(P>0.05),while SAS score and SDS score in study group were statistically significantly lower than those in control group 5 days after PCI(P<0.05).(2)No statistically significant difference of LVEF or LVEDV was found between the two groups before PCI,nor was LVEDV 5 days after PCI(P>0.05);5 days after PCI,LVEF in study group was statistically significantly higher than that in control group,moreover 6-minute walking distance in study group was statistically significantly longer than that in control group(P<0.05).(3)No statistically significant difference of incidence of adverse cardiovascular events was found between the two groups during intervention(P>0.05). Conclusion Psychosomatic comprehensive nursing care can effectively relieve the negative emotion and improve the cardiac function in postoperative AMI patients complicated with left heart failure treated by PCI.