急性心肌梗死介入术后患者营养风险相关影响因素及护理策略

Influencing factors and nursing strategies of nutritional risk in patients with acute myocardial infarction after interventional operation

目的分析影响急性心肌梗死介入术后患者发生营养不良的相关危险因素,为康复护理干预措施的制定提供科学依据。方法采用横断面研究法,根据营养筛查量表将苏州市立医院本部在2018年8月至2020年8月期间心内科收治的急性心肌梗死介入术患者60例,分为营养正常组(38例)和营养不良组(22例)。使用一般资料调查问卷、营养风险筛查2002(Nutritional Risk Screening,NRS2002)、依从性调查问卷、视觉模拟量表(Visual Analogue Scale,VAS)、急性生理学及慢性健康状况评分系统(Acute Physiology and Chronic Health EvaluationⅡ,APACHEⅡ)等调查工具,对其进行单因素分析及Logistic多因素分析。结果60例急性心肌梗死介入术后患者中,男41例、女19例;年龄>60岁39例、≤60岁21例;Killip心功能分级Ⅱ级36例、Ⅲ级24例;年龄、依从性、疼痛等为急性心肌梗死介入术后患者营养不良的相关因素(P<0.05);Logistic回归分析结果显示,年龄>60岁、依从性评分≤75分、术后疼痛≥4分等均为急性心肌梗死介入术后患者营养不良的独立危险因素(均P<0.05)。结论急性心肌梗死介入术后患者营养不良发生率较高,其中年龄大、依从性差、疼痛等为独立危险因素,护理人员需加强体征监测、宣教指导、疼痛管理及术肢康复指导等干预,降低营养不良发生率。

Objective To analyze the related risk factors of malnutrition in patients with acute myocardial infarction after interventional surgery,and to provide scientific basis for the formulation of rehabilitation nursing intervention measures.Methods A cross-sectional study was adopted in this study,according to the nutrition screening scale,60 patients with acute myocardial infarction treated in this hospital from August 2018 to August 2020 were divided,normal nutrition group(n=38)and malnutrition group(n=22).General Information Questionnaire,Nutritional Risk Screening 2002(NRS2002),compliance questionnaire,Visual Analogue Scale(VAS),Acute Physiology and Chronic Health Evaluation(APACHE)Ⅱand other survey tools were used to perform univariate analysis and Logistic multivariate analysis.Results Among 60 patients with acute myocardial infarction after interventional operation,41 were males and 19 were females.Thirty-nine cases with age>60 years old and 21 cases with age≤60 years old.Killip cardiac function gradeⅡ(36 cases)andⅢ(24 cases).Thirty-eight patients with Patient Generated Subjective Global Assessment(PG-SGA)score≤10 and 22 patients with PG-SGA score>10.Age,compliance,pain and other factors related to malnutrition in patients with acute myocardial infarction after intervention(P<0.05).Logistic regression analysis showed that,Age>60 years old,compliance score≤75 points,postoperative pain≥4 points are independent risk factors for malnutrition in patients with acute myocardial infarction after intervention(P<0.05).Conclusions Patients with acute myocardial infarction after intervention have a high incidence of malnutrition,among which old age,poor compliance,pain and other independent risk factors,nursing staff should strengthen signs monitoring,education and guidance,pain management and operative limb rehabilitation and other interventions to reduce the incidence of malnutrition.