冠状动脉支架植入术后心脏功能康复质量的影响因素及护理策略

Impacting factors and nursing strategies of cardiac function rehabilitation quality after coronary stent implantation

目的研究影响冠状动脉支架植入术后心脏功能康复质量的因素并探讨相关护理策略。方法选择2019年1月至2020年12月在广东医科大学附属医院心血管内科行冠状动脉支架植入术治疗的206例患者,在术后6个月使用中国心血管病人生活质量评定问卷(CQQC)对其进行回访,并记录其一般资料及康复期间接受的护理措施,根据问卷结果将患者分为心脏功能康复良好组(168例)与心脏功能康复不良组(38例),用单因素分析及logistic多元回归模型分析影响心脏功能康复质量的相关因素。结果心脏功能康复良好组的体力、病情、一般生活状况、工作状况、社会心理状况、总分均明显比心脏功能康复不良组高,差异有统计学意义(P<0.05),两组间的高龄占比、肥胖[体重指数(BMI)≥28 kg/m2]、累及冠状动脉数量>2支、吸烟占比、接受心脏功能康复锻炼占比、药物依从性、合并基础病数量等差异有统计学意义(P<0.05);logistic多元回归分析显示,高龄、肥胖、药物依从性差、不合理的心脏康复锻炼、吸烟、病变累及的冠状动脉数量>2支、基础疾病的数量≥2种等是影响心脏功能康复的危险因素(P<0.05)。结论年龄、BMI、药物依从性、合理的锻炼等均为影响心脏功能康复的相关因素,应根据患者制订个性化的治疗方案,以达到更好的心脏功能康复效果。

Objective To investigate the impacting factors of cardiac function rehabilitation quality after coronary stent implantation and explore the relevant nursing strategies.Methods A total of 206 patients who underwent coronary stent implantation in the Department of Cardiovascular Internal Medicine of the Affiliated Hospital of Guangdong Medical University from January 2019 to December 2020 were selected.Six months after the operation,they were followed up with the Chinese questionnaire of quality of life in patients with cardiovascular diseases(CQQC),and their general information and nursing measures during the rehabilitation period were recorded.According to the questionnaire results,patients were divided into the good cardiac function rehabilitation group(the good group)(n=168)and the poor cardiac function rehabilitation group(the poor group)(n=38).Univariate analysis and logistic multiple regression were adopted to analyze the related factors impacting the quality of cardiac function rehabilitation.Results The physical strength,illness,general living conditions,working conditions,social psychological conditions,and total scores of the good group were all significantly higher than those of the poor group,with statistically significant differences(P<0.05).There were statistically significant differences between the two groups in the proportion of old age,body mass index(BMI)(BMI≥28 kg/m2),the number of coronary arteries involved>2,the proportion of smoking,the proportion of receiving cardiac function rehabilitation exercise,drug compliance and the number of complicated basic diseases(P<0.05).Logistic multiple regression analysis showed that old age,BMI,poor drug compliance,unreasonable cardiac rehabilitation exercise,smoking,the number of coronary arteries involved by pathological changes(>2),and the number of basic diseases(≥2)were the risk factors impacting cardiac function rehabilitation(P<0.05).Conclusion Age,BMI,drug compliance and reasonable exercise are all relevant factors that impact cardiac function rehabilitation.Personalized treatment should be formulated according to the conditions of patients so as to achieve better cardiac function rehabilitation efficacy.