量化评估策略指导下手术室护理在冠脉搭桥术围术期老年冠心病患者中的应用效果

Application of quantitative assessment-guided operating room nursing in elderly patients with coronary heart disease in perioperative period of coronary artery bypass grafting

目的探讨量化评估策略指导下手术室护理在冠脉搭桥术围术期老年冠心病患者中的应用效果,以期为临床治疗提供参考。方法选取天津市胸科医院2018年10月—2021年10月收治的60例行冠脉搭桥术的老年冠心病患者为研究对象。采用随机数字表法,将患者分为研究组(n=30)与对照组(n=30)。对照组患者采取常规护理,研究组患者采取量化评估策略指导下手术室护理。比较2组患者术后到出院期间并发症发生情况。比较2组患者术后1d及术后1个月时的6分钟步行距离、左心室射血分数(LVEF)、B型利钠肽(BNP)等心功能指标。比较2组患者术后1d、术后3个月、术后6个月时的简明生活质量量表(SF-36)及日常生活活动能力(ADL)评分。结果研究组患者术后并发症发生率低于对照组,差异有统计学意义(P<0.05)。术后1d,2组患者6分钟步行距离、LVEF、BNP水平比较,差异无统计学意义(P>0.05)。术后1个月,2组患者6分钟步行距离、LVEF大于术后1d,且研究组大于对照组,差异均有统计学意义(P<0.05)。术后1个月,2组患者BNP水平低于术后1d,且研究组低于对照组,差异均有统计学意义(P<0.05)。术后1d,2组患者ADL及SF-36评分比较,差异无统计学意义(P>0.05)。术后1个月及术后6个月时,2组患者ADL及SF-36评分均高于术后1d,且研究组高于对照组,差异均有统计学意义(P<0.05)。术后6个月时,2组患者ADL及SF-36评分均高于术后1个月,且研究组高于对照组,差异均有统计学意义(P<0.05)。结论对冠脉搭桥围术期老年冠心病患者采取量化评估策略指导下手术室护理方案可以进一步降低患者术后并发症发生率,促进患者心功能的恢复,提高患者生活质量与日常生活能力,值得临床推广应用。

Objective This paper aims to investigate the effect of quantitative assessment-guided operating room nursing in the perioperative period of coronary artery bypass grafting(CABG)in elderly patients with coronary heart disease(CHD),so as to provide evidence clinically.Methods Sixty elderly patients with CHD who underwent CABG from October 2018 to October 2021 in Tianjin Chest Hospital were selected as the study participants.They were allocated to the study group(n=30)and control group(n=30)by random number table.Patients in the control group received routine care;patients in the study group,operating room nursing guided by quantitative assessment.Postoperative complications until discharge were compared between the two groups.The 6-minute walk distance,left ventricular ejection fraction(LVEF),B-type natriuret-ic peptide(BNP),and other cardiac function parameters were compared between the groups at 1 d and 1 month after opera-tion.The scores of the 36-Item Short-Form Health Survey(SF-36)and Activities of Daily Living(ADL)were compared be-tween the two groups at 1 d,3 months,and 6 months after operation.Results The incidence rate of postoperative compli-cations in the study group was significantly lower than that in the control group(P<0.05).There was no significant differ-ence in 6-minute walk distance,LVEF and BNP levels 1 d after operation between the groups(P>0.05).At 1 month after operation,the 6-minute walk distance and LVEF in the two groups were greater than those at 1 d after operation,and the study group was greater than the control group,with statistical significance(P<0.05).One month after operation,the BNP level in the two groups was lower than that 1 d after operation,and the study group was lower than the control group,with statistical significance(P<0.05).At 1 d after operation,there was no significant difference in ADL and SF-36 scores between the groups(P>0.05).At 1 month and 6 months after operation,ADL and SF-36 scores in the two groups were higher than those at 1 d after operation,and the study group was higher than the control group,with statistical significance(P<0.05).At 6 months after operation,ADL and SF-36 scores in the two groups were higher than those at 1 month after operation,and the study group was higher than the control group,with statistical significance(P<0.05).Conclusion Quantitative assessment-guided operating room nursing in elderly patients with CHD during the perioperative period of CABG can further reduce the incidence of postoperative complications,promote the recovery of cardiac function,and in-crease the quality of life and activities of daily living.These benefits hold promise for a wider application of this technique clinically.