基于FMEA模式的康复护理在冠心病合并糖尿病患者PCI围术期的干预效果

Intervention effect of rehabilitation nursing based on failure mode and effect analysis model in patients with coronary heart disease complicated with diabetes during perioperative period of percutaneous coronary intervention

目的研究基于失效模式与效应分析(FMEA)模式的康复护理在冠心病合并糖尿病患者冠状动脉介入(PCI)围术期的干预效果。方法选取上海中医药大学附属曙光医院2020年8月至2021年6月期间收治的60例均行PCI术的冠心病合并糖尿病患者作为研究对象,按随机数表法分为研究组和对照组,各30例。对照组患者采用常规护理,研究组患者采用基于FMEA模式的康复护理。两组患者均连续干预6个月,记录并比较两组患者在干预前后的收缩压(SBP)、舒张压(DBP)、空腹血糖(FPG)、餐后2 h血糖(2 hPG)水平,并采用健康调查量表(SF-36)评价两组患者的生活质量,同时比较两组患者的并发症发生率和对护理的满意度。结果干预前,两组患者的SBP、DBP、FPG、2 hPG比较差异均无统计学意义(P>0.05);干预后,两组患者的SBP、DBP、FPG、2 hPG水平均明显降低,且研究组患者的SBP、DBP、FPG、2 hPG水平分别为(132.48±6.02)mmHg、(84.95±2.36)mmHg、(7.63±1.27)mmol/L、(7.26±1.38)mmol/L,明显低于对照组的(152.56±5.89)mmHg、(93.46±2.18)mmHg、(8.59±1.58)mmol/L、(9.62±2.03)mmol/L,差异均有统计学意义(P<0.05);干预6个月后,研究组患者的躯体功能、社会功能、认知功能、情绪功能、角色功能的评分分别为(73.58±7.54)分、(79.26±10.06)分、(72.08±8.06)分、(68.69±10.26)分、(77.63±9.06)分,明显高于对照组的(68.56±8.03)分、(72.57±9.68)分、(66.57±7.16)分、(63.57±8.62)分、(68.27±8.26),差异均有统计学意义(P<0.05);研究组患者的并发症发生率为3.33%,明显低于对照组的20.00%,患者对护理的满意度为93.33%,明显高于对照组的73.33%,差异均有统计学意义(P<0.05)。结论冠心病合并糖尿病患者PCI围术期采用基于FMEA模式的康复护理,能有效控制患者的血压与血糖,降低患者并发症的发生率,提高患者的满意度与术后生活质量,具有临床应用价值。

Objective To study the intervention effect of rehabilitation nursing based on failure mode and effect analysis(FMEA)model in the perioperative period of percutaneous coronary intervention(PCI)in patients with coronary heart disease and diabetes.Methods Sixty patients with coronary heart disease complicated with diabetes who underwent PCI in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from August 2020 to June 2021 were selected as the research objects.According to random number table method,they were randomly divided into the study group and the control group,with 30 patients in each group.The patients in the control group received routine nursing,and the patients in the study group received rehabilitation nursing based on FMEA mode.Both groups were continuously intervened for 6 months.The systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting blood glucose(FPG),and 2 h postprandial blood glucose(2 hPG)levels before and after the intervention were recorded and compared between the two groups.The quality of life between the two groups was evaluated by health survey scale(SF-36),and the incidence of complications and satisfaction with nursing were compared between the two groups.Results Before the intervention,there was no significant difference in SBP,DBP,FPG,and 2 hPG between the two groups(P>0.05).After the intervention,the levels of SBP,DBP,FPG,and 2 hPG in the two groups decreased significantly,and the levels in the study group were(132.48±6.02)mmHg,(84.95±2.36)mmHg,(7.63±1.27)mmol/L,and(7.26±1.38)mmol/L,significantly lower than(152.56±5.89)mmHg,(93.46±2.18)mmHg,(8.59±1.58)mmol/L,and(9.62±2.03)mmol/L in the control group(P<0.05).After 6 months of intervention,the scores of physical function,social function,cognitive function,emotional function,and role function in the study group were(73.58±7.54)points,(79.26±10.06)points,(72.08±8.06)points,(68.69±10.26)points,and(77.63±9.06)points,which were significantly higher than(68.56±8.03)points,(72.57±9.68)points,(66.57±7.16)points,(63.57±8.62)points,and(68.27±8.26)points in the control group(P<0.05).The incidence of complications in the study group was 3.33%,which was significantly lower than 20.00%in the control group,and the patients'satisfaction with nursing was 93.33%,significantly higher than 73.33%in the control group(P<0.05).Conclusion The rehabilitation nursing based on FMEA model in the peri-operative period of PCI for patients with coronary heart disease and diabetes can effectively control their blood pres-sure and blood glucose,reduce the incidence of complications,and improve their satisfaction and postoperative quality of life.