直接经冠脉介入治疗与溶栓联合直接经冠脉介入治疗急性心肌梗死的疗效观察

目的比较直接经冠脉介入治疗(PCI)与溶栓联合PCI治疗急性心肌梗死患者的近期疗效。方法采用随机双盲法将100例急性心肌梗死患者分为两组,每组50例,对照组采取PCI治疗,观察组则行溶栓联合PCI治疗,比较两组临床疗效、并发症及治疗前后左心射血分数(LVEF)、6min步行试验(6-MWT)指标。结果察组IRA再通、ST段下移、胸痛症状缓解发生率显著高于对照组,差异有统计学意义(P<0.05)。观察组治疗后3个月的LVEF显著优于对照组,差异有统计学意义(P<0.01)。两组并发症发生率差异无统计学意义(P>0.05)。结论溶栓联合PCI治疗急性心肌梗死相比直接PCI效果更佳,IRA再通率明显更高,心功能改善更明显。

不同方法经冠脉介入治疗ST段抬高心肌梗死的远期疗效

目的:探讨不同方法经冠脉介入治疗ST段抬高心肌梗死(STEMI)的远期疗效。方法:选取2013年5月~2015年1月于我院行冠脉介入治疗(PCI)的STEMI患者100例为研究对象,随机分为实验组和参照组各50例。参照组行梗死相关动脉PCI治疗,实验组于冠脉内注射替罗非班联合血栓抽吸后行梗死相关动脉PCI治疗,比较两组患者病变血管TIMI血流分级及术后10 d LVEF、BNP水平,两组冠脉慢血流发生率、术后2 h ST段50%回落率、心血管不良事件发生率。结果:实验组病变血管TIMI血流分级、术后10 d LVEF水平明显高于参照组,BNP水平低于参照组(P<0.05);实验组冠脉慢血流发生率低于参照组,术后2 h ST段50%回落率高于参照组(P<0.05);两组心血管不良事件发生率比较无显著性差异(P>0.05)。结论:冠脉内注射替罗非班联合血栓抽吸后行梗死相关动脉PCI治疗可明显改善ST段抬高心肌梗死患者ST段回落情况及心肌功能,缩小心肌坏死范围,提高临床疗效。

Family care and subjective well-being of coronary heart disease patients after percutaneous coronary intervention:Mediating effects of coping strategies

Objectives To analyze the correlations between family care,coping strategies and the subject well-being(SWB)of patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI).Methods From November 2019 to October 2020,264 CHD patients who had undergone PCI were enrolled in this questionnaire survey.The research tools applied included General Information Questionnaire,the Adaptation,Partnership,Growth,Affection and Resolve,Medical Coping Modes Questionnaire,and the General Well-being Schedule.SPSS 24.0 and Amos 23.0 software packages were used for statistical analysis.Results The mean scores for family care,confrontation,avoidance,acceptance-resignation and SWB,were 7.59±2.24,20.03±3.78,16.49±2.70,10.42±2.01,and 73.31±11.63,respectively.Subgroup analysis showed that the path coefficient between family care and subjective well-being was higher in males than females.Family care was directly related to coping strategies.The coping strategies were directly related to SWB,while family care showed an indirect association with SWB via coping strategies.Conclusions Family care can improve CHD patients’SWB post-PCI,and coping strategies are important for the link between family care and SWB.Also,men received more family care than women.Based on a patient's characteristics,healthcare providers can promote patients’positive coping strategies,increase their perceived family care,and improve the patient's SWB.

Effects of multidisciplinary exercise management on patients after percutaneous coronary intervention:A randomized controlled study

Objectives To explore the effectiveness of the mobile app-based multidisciplinary exercise management on patients who receive percutaneous coronary intervention(PCI).Methods From January to October 2020,54 patients after PCI were randomly assigned to the intervention group(n=27)and the control group(n=27).The intervention group received the mobile app-based multidisciplinary exercise management,whereas the control group received routine care.The patients after PCI began to take intervention one month after the operation,and the intervention lasted for two months.Before and after the intervention,6-Minute Walking Distance was used to evaluate the patient’s exercise tolerance,and the patient’s exercise compliance was evaluated according to the patient’s exercise status recorded by the mobile app.The cognitive questionnaire on knowledge about PCI treatment for Coronary Heart Disease,the Self-efficacy for Chronic Disease Scale and the Perceived Social Support Scale were used to evaluate patients’disease-related cognition,self-efficacy and perception of social support.This study was registered on Clinical Trials.gov with registration number ChiCTR2000028930.Results Totally 51 patients after PCI who completed this study(25 patients in the intervention group and 26 patients in the control group)were included in the analysis.After 2 months of intervention,the exercise compliance of patients in the intervention group was better than that in the control group.And 6-Minute Walking Distance(469.36±57.48 vs.432.81±67.09),and the scores of knowledge of PCI treatment for coronary heart disease(52.64±9.82 vs.42.42±8.54),Self-efficacy for Chronic Disease Scale(42.40±8.04 vs.36.88±7.73)and Perceived Social Support Scale(74.04±5.73 vs.66.69±6.86)in the intervention group were higher than those in the control group with statistical significance(P<0.05).Conclusions The multidisciplinary exercise management based on the mobile app can effectively improve exercise tolerance,exercise compliance,disease-related cognition,self-efficacy,and perception of social support during exercise training for patients after PCI.

Retrospective analysis of exercise capacity in patients with coronary artery disease after percutaneous coronary intervention or coronary artery bypass graft

Objectives:To describe the current state of exercise capacity as well as to identify its predictors in patients with coronary artery disease (CAD) following percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) in the mainland of China.Methods:A retrospective study design was employed.We evaluated 230 CAD patients following PCI or CABG in a cardiac rehabilitation center from January 2019 to October 2019.The patients were referred to undergo incremental cardiopulmonary exercise testing with a cycle ergometer.The Zung Self-Rating Anxiety Scale and the Zung Self-Rating Depression Scale were used to evaluate patients' mental health.Statistical analysis was performed using the chi-square test,Fisher's exact test,t-test,Mann-Whitney U test,and binary logistic regression.Results:Among the 230 patients,223 patients demonstrated reduced exercise capacity.Resutlts of the logistic regression analysis showed that anxiety (OR =1.13,95% CI 1.01-1.32,P =0.029) was an independent risk factor for reduced exercise capacity in patients following the PCI or CABG.Conclusions:Exercise capacity of Chinese CAD patients after PCI or CABG was relatively poor.Alleviating symptoms of anxiety and making exercise prescriptions according to the results of the cardiopulmonary exercise test should be considered during the intervention to improve CAD patients' exercise capacity.

Coronary arteriography under acupuncture anesthesia:a case report

Acupuncture anesthesia is a technique by partially or completely replacing anesthetics with acupuncture in surgery based on the traditional acupuncture analgesia mechanism.It emerged in the 1950s,went viral in the 1970s and then gradually fell into decline.In the recent years,this technique has regained attention and further research.Acupuncture anesthesia can be classified as either pure acupuncture anesthesia or acupuncture-medication combined anesthesia.To expand the application of this technique,a patient with non-ST elevation acute coronary syndrome in urgent need of percutaneous coronary intervention (PCI) received pure acupuncture anesthesia because of an allergy to lidocaine,and the operation went successfully.This is the first time that pure acupuncture anesthesia and coronary arteriography were combined,which is of great significance in further study and development of acupuncture anesthesia.