Triangle分层分级管理对急性非ST段抬高型心肌梗死患者PCI术后心肺功能、自我效能及生活质量的影响

Impact of Triangle hierarchical management on cardiopulmonary function,self-efficacy and quality of life in patients with acute non-ST-segment elevation myocardial infarction after PCI

目的:探讨Triangle分层分级管理用于急性非ST段抬高型心肌梗死(NSTEMI)患者经皮冠状动脉介入(PCI)术后的临床效果。方法:选择2019年1月至2022年12月在我院行PCI术的NSTEMI患者107例。按照随机数表法,患者被分为对照组(n=53)和观察组(n=54)。对照组患者接受常规康复训练,观察组在对照组基础上,采用Triangle分层分级管理,均干预6个月。比较两组干预前后的心肺功能指标,心肌梗死多维度评估量表(MIDAS)和一般自我效能感量表(GSES)评分,并比较两组随访期间的不良事件情况。结果:研究过程中对照组脱落2例,观察组中途退出1例,最终入组分别为51例和53例。与对照组相比,观察组干预后第1秒用力呼气量(FEV1)[(2.98±0.27)L比(3.30±0.35)L]、一秒率(FEV1/FVC)[(72.65±4.31)%比(77.06±3.95)%]和GSES评分[(18.53±2.63)分比(26.89±3.19)分]均显著升高,而MIDAS总分[(65.53±4.86)分比(56.26±4.38)分]显著下降(P均<0.001)。对照组和观察组患者随访期间不良事件的发生率无显著差异(13.73%比7.55%,P=0.306)。结论:Triangle分层分级管理用于急性非ST段抬高型心肌梗死患者行PCI术后,能显著改善肺功能,提高自我效能和生活质量,同时安全性较高,值得在临床上推广。

Objective:To explore the clinical effect of Triangle hierarchical management in patients with acute non-ST-segment elevation myocardial infarction(NSTEMI)after percutaneous coronary intervention(PCI).Methods:A total of 107 NSTEMI patients who underwent PCI in our hospital from Jan 2019 to Dec 2022 were selected.According to the random number table method,patients were divided into control group(n=53)and observation group(n=54).Patients in the control group received routine rehabilitation training,while observation group received Triangle hierarchical management based on control group,both groups were intervened for 6 months.Cardiopulmonary function indexes,scores of myocardial infarction dimensional assessment scale(MIDAS)and general self-efficacy scale(GSES)before and after intervention,and incidence of adverse events during follow-up were compared between two groups.Results:During study period,two cases were lost in the control group and one case withdrew in the observation group,with 51 and 53 cases finally enrolled in each group,respectively.Compared with the control group after intervention,there were significant rise in forced expiratory volume in one second(FEV1)[(2.98±0.27)L vs.(3.30±0.35)L],FEV1/forced vital capacity(FVC)[(72.65±4.31)%vs.(77.06±3.95)%]and GSES score[(18.53±2.63)points vs.(26.89±3.19)points],and significant reduction in MIDAS total score[(65.53±4.86)points vs.(56.26±4.38)points]in observation group(P<0.001 all).There was no significant difference in the incidence rate of adverse events between control group and observation group during follow-up(13.73%vs.7.55%,P=0.306).Conclusion:Triangle hierarchical management may significantly improve lung function,self-efficacy and quality of life with high safety in patients with acute non-ST-segment elevation myocardial infarction after PCI,suggesting that it worths promoting in clinical practice.