全方位护理对急性ST段抬高型心肌梗死患者经皮冠状动脉介入治疗术后近期预后的影响

目的 探讨全方位护理对行经皮冠状动脉介入治疗(PCI)术后的急性ST段抬高型心肌梗死(STEMI)患者近期预后的影响.方法 回顾性分析2018年1月至2020年2月本院收治的确诊STEMI并进行PCI治疗的患者140例,分为常规护理组(63例)与全方位护理组(77例).比较其生活质量、心理状态、心功能以及术后30 d主要心血管不良事件发生情况和死亡情况,同时分析发生死亡的危险因素.结果 全方位护理组生活质量、焦虑自评量表(SAS)及抑郁自评量表(SDS)评分及心功能相关指标改善程度显著高于常规护理组(P<0.001),且该组术后30 d主要心血管不良事件发生率显著降低(P<0.001);经验证Killip心功能分级Ⅲ级及冠状造影多支病变是患者死亡的危险因素,而全方位护理模式方案是患者康复的保护因素(P<0.05).结论 对PCI术后STEMI患者实行全方位护理方案可有效提高患者术后生活质量、改善患者心理状态及心功能,且可有效降低术后30 d主要心血管不良事件发生从而改善患者预后.

Objective To investigte the effect of comprehensive nursing on short-term prognosis of patients with acute ST segment elevation myocardial infarction undergoing PCI.Methods A total of 140 patients with STEMI diagnosed and treated with PCI fom January 2018 to February 2020 in our hospial were selected for the retrospective analysis,and they were divided into the conventional care group(63 cases)and the ll-round care group(77 cases).The quality of life,psychological status,cardiac function,major adverse cardiovascular events and mortality 30 days afer PCI were compared,and the risk factors of death were analyzed.ResultsThe quality of life,SAS and SDS scores,as well as cardiac function related indexes,were significantly beter in the all-round care group(P<0.001).The ll-round care group also had a significantly lower rate of major adverse cardiovascular events at 30 d postoperatively(x^(2)=10.739),and the survival ime disributions weresigifcantly diferet betwee the two groups(x^(2)=4.968).Kli fiunctioal cls and mulivssel disease on coronary angiography were validated as risk factors for mortality in our patient population,whereas care protocol was protective against mortality(P<0.05).Conclusion Comprehensive nursing program can effectively improve the quality of life,psychologial state and cardiac function of STEMI atients fer PCI,and can ffectively reduce the incidence of major cardiovasculradverse events 30 daysafe surgery.