目的对在不稳定性心绞痛患者的介入治疗中采取临床护理路径的效果进行Meta分析。方法通过计算机检索2010~2015年的维普、知网、万方与中国生物医学等数据库中有关临床护理路径在不稳定性心绞痛患者介入治疗中应用效果的文献资料,按照排...目的对在不稳定性心绞痛患者的介入治疗中采取临床护理路径的效果进行Meta分析。方法通过计算机检索2010~2015年的维普、知网、万方与中国生物医学等数据库中有关临床护理路径在不稳定性心绞痛患者介入治疗中应用效果的文献资料,按照排除与纳入的标准对文献进行筛选与评估,使用软件包Rev Man 5.1.2对文献进行处理,并实行Meta分析。结果选入的文献共有5篇,受试者共338例,实验组与参照组各169例。文献质量评级大部分为B级,只有1篇是C级。Meta分析的结果表明,实验组的平均住院时间（8.21±1.56）d显著少于参照组（9.26±1.34）d;实验组对护理工作的满意度为98.9%,显著高于参照组的88.3%,2组数据比较差异均有统计学的意义（P〈0.05）。结论临床护理路径在接受介入治疗的不稳定心绞痛患者的护理中有较好的效果,能够提高患者对护理的满意度。如想进一步了解临床护理路径的实践效果,应收集更多的文献资料进行具体分析。展开更多
Objectives To evaluate the prognostic value of the coronary artery calcium （CAC） score in patients with stable angina pectoris （SAP） who underwent percutaneous coronary intervention （PCI）. Methods A total of 334...Objectives To evaluate the prognostic value of the coronary artery calcium （CAC） score in patients with stable angina pectoris （SAP） who underwent percutaneous coronary intervention （PCI）. Methods A total of 334 consecutive patients with SAP who underwent first PCI following multi-slice computer tomography （MSCT） were enrolled from our institution between January 2007 and June 2012. The CAC score was calculated according to the standard Agatston calcium scoring algorithm. Complex PCI was defined as use of high pressure bal-loon, kissing balloon and/or rotablator. Procedure-related complications included dissection, occlusion, perforation, no/slow flow and emer-gency coronary artery bypass grafting. Main adverse cardiac events （MACE） were defined as a combined end point of death, non-fatal myo-cardial infarction, target lesion revascularization and rehospitalization for cardiac ischemic events. Results Patients with a CAC score〉300 （n=145） had significantly higher PCI complexity （13.1%vs. 5.8%, P=0.017） and rate of procedure-related complications （17.2%vs. 7.4%, P=0.005） than patients with a CAC score≤300 （n=189）. After a median follow-up of 22.5 months （4-72 months）, patients with a CAC score≤300 differ greatly than those patients with CAC score＆gt;300 in cumulative non-events survival rates （88.9 vs. 79.0%, Log rank 4.577, P=0.032）. After adjusted for other factors, the risk of MACE was significantly higher [hazard ratio （HR）：4.3, 95%confidence inter-val （95%CI）：2.4-8.2, P=0.038] in patients with a CAC score〉300 compared to patients with a lower CAC score. Conclusions The CAC score is an independent predictor for MACE in SAP patients who underwent PCI and indicates complexity of PCI and proce-dure-related complications.展开更多
文摘目的对在不稳定性心绞痛患者的介入治疗中采取临床护理路径的效果进行Meta分析。方法通过计算机检索2010~2015年的维普、知网、万方与中国生物医学等数据库中有关临床护理路径在不稳定性心绞痛患者介入治疗中应用效果的文献资料,按照排除与纳入的标准对文献进行筛选与评估,使用软件包Rev Man 5.1.2对文献进行处理,并实行Meta分析。结果选入的文献共有5篇,受试者共338例,实验组与参照组各169例。文献质量评级大部分为B级,只有1篇是C级。Meta分析的结果表明,实验组的平均住院时间（8.21±1.56）d显著少于参照组（9.26±1.34）d;实验组对护理工作的满意度为98.9%,显著高于参照组的88.3%,2组数据比较差异均有统计学的意义（P〈0.05）。结论临床护理路径在接受介入治疗的不稳定心绞痛患者的护理中有较好的效果,能够提高患者对护理的满意度。如想进一步了解临床护理路径的实践效果,应收集更多的文献资料进行具体分析。
文摘Objectives To evaluate the prognostic value of the coronary artery calcium （CAC） score in patients with stable angina pectoris （SAP） who underwent percutaneous coronary intervention （PCI）. Methods A total of 334 consecutive patients with SAP who underwent first PCI following multi-slice computer tomography （MSCT） were enrolled from our institution between January 2007 and June 2012. The CAC score was calculated according to the standard Agatston calcium scoring algorithm. Complex PCI was defined as use of high pressure bal-loon, kissing balloon and/or rotablator. Procedure-related complications included dissection, occlusion, perforation, no/slow flow and emer-gency coronary artery bypass grafting. Main adverse cardiac events （MACE） were defined as a combined end point of death, non-fatal myo-cardial infarction, target lesion revascularization and rehospitalization for cardiac ischemic events. Results Patients with a CAC score〉300 （n=145） had significantly higher PCI complexity （13.1%vs. 5.8%, P=0.017） and rate of procedure-related complications （17.2%vs. 7.4%, P=0.005） than patients with a CAC score≤300 （n=189）. After a median follow-up of 22.5 months （4-72 months）, patients with a CAC score≤300 differ greatly than those patients with CAC score＆gt;300 in cumulative non-events survival rates （88.9 vs. 79.0%, Log rank 4.577, P=0.032）. After adjusted for other factors, the risk of MACE was significantly higher [hazard ratio （HR）：4.3, 95%confidence inter-val （95%CI）：2.4-8.2, P=0.038] in patients with a CAC score〉300 compared to patients with a lower CAC score. Conclusions The CAC score is an independent predictor for MACE in SAP patients who underwent PCI and indicates complexity of PCI and proce-dure-related complications.
