冠心病PTCA病人术后疾病管理能力及心理状况与心血管意外事件发生的关系研究

Relationship between postoperative disease management ability,psychological status and cardiovascular accidents in patients with coronary heart disease after PTCA

[目的]探讨冠心病经皮冠状动脉腔内成形术(PTCA)病人术后疾病管理能力及心理状况与术后心血管意外事件发生的关系。[方法]选取2018年3月—2019年3月某院心内科收治的92例冠心病PTCA病人为研究对象,根据病人术后是否发生心血管意外事件将病人分为无心血管意外组68例和合并心血管意外组24例,应用冠心病自我管理行为量表(CSMS)、焦虑自评量表(SAS)、抑郁自评量表(SDS)对两组病人进行评价,分别应用单因素及多元回归分析影响冠心病PTCA病人术后心血管意外发生的相关因素。[结果]无心血管意外组病人CSMS评分及各维度评分高于合并心血管意外组(P<0.05),而SAS评分、SDS评分低于合并心血管意外组(P<0.05)。经多元回归分析可知,病人植入支架数、SAS评分、SDS评分是引起冠心病PTCA病人术后心血管意外事件发生的危险因素(P<0.05),而CSMS评分是冠心病PTCA病人术后心血管意外事件发生的保护因素(P<0.05)。[结论]冠心病PTCA病人术后疾病管理能力及心理状况与术后心血管意外事件发生有密切的关系,提供病人疾病管理能力,减轻病人不良情绪将有助于预防心血管意外事件发生。

Objective:To investigate the relationship between postoperative disease management ability,psychological status and postoperative cardiovascular accidents in patients with coronary heart disease after percutaneous transluminal coronary angioplasty(PTCA).Methods:A total of 92 patients with coronary heart disease undergoing PTCA admitted to the department of Cardiology in a hospital from March 2018 to March 2019 were selected as the research objects.According to the occurrence of postoperative cardiovascular accidents,the patients were divided into cardiovascular accidents group with 68 patients and non-cardiovascular accidents group with 24 patients.The Coronary heart disease Self-Management Scale(CSMS),Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)were used to evaluate the patients in the two groups,and the factors influencing the occurrence of cardiovascular accidents of patients with coronary heart disease undergoing PTCA were analyzed by single factor and multiple regression respectively.Results:The CSMS and all dimension scores of patients in non-cardiovascular accidents were higher than those in the group with cardiovascular accidents(P<0.05),while the SAS and SDS scores were lower than those in the group with cardiovascular accidents(P<0.05).Multiple regression analysis showed that the number of stents implanted,SAS score and SDS score were risk factors for cardiovascular accidents in patients with coronary heart disease after PTCA(P<0.05),while CSMS score was a protective factor for cardiovascular accidents in patients with coronary heart disease after PTCA(P<0.05).Conclusions:Postoperative disease management ability and psychological status of patients with coronary heart disease after PTCA were closely related to the occurrence of postoperative cardiovascular accidents.Improving patients′disease management ability and alleviating patients′negative emotions will help to prevent cardiovascular accidents.