身心综合护理对急性心肌梗死并左心衰竭患者经皮冠状动脉介入治疗后负性情绪及心功能的影响
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摘要
目的探讨身心综合护理对急性心肌梗死(AMI)并左心衰竭患者经皮冠状动脉介入治疗(PCI)后负性情绪及心功能的影响。方法选取2017年1月—2018年5月在淮安市第二人民医院行PCI的AMI并左心衰竭患者60例,采用随机数字表法分为对照组和研究组,每组30例。对照组患者给予冠心病重症监护室(CCU)常规护理,研究组患者在对照组基础上给予身心综合护理(包括心理护理和心脏康复运动);两组患者均连续干预5 d。比较两组患者PCI后第1天、第5天焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分,PCI前及PCI后第5天左心室射血分数(LVEF)、左心室舒张末期容积(LVEDV)及PCI后第5天6分钟步行距离(6MWD),并观察干预期间两组患者不良心血管事件发生情况。结果 (1)PCI后第1天两组患者SAS、SDS评分比较,差异无统计学意义(P>0.05);PCI后第5天研究组患者SAS评分、SDS评分低于对照组(P<0.05)。(2)PCI前两组患者LVEF、LVEDV及PCI后第5天LVEDV比较,差异无统计学意义(P>0.05);PCI后第5天研究组患者LVEF高于对照组,6MWD长于对照组(P<0.05)。(3)两组患者干预期间不良心血管事件发生率比较,差异无统计学意义(P>0.05)。结论身心综合护理可有效改善AMI并左心衰竭患者PCI后负性情绪及心功能。
Objective To investigate the impact of psychosomatic comprehensive nursing care on negative emotion and cardiac function in postoperative acute myocardial infarction(AMI)patients complicated with left heart failure treated by PCI. Methods A total of 60 postoperative AMI patients complicated with left heart failure treated by PCI were selected in the Second People's Hospital of Huai'an from January 2017 to May 2018,and they were divided into control group and study group according to random number table method,with 30 cases in each group. Patients in control group received routine CCU nursing care,while patients in study group received psychosomatic comprehensive nursing care(including psychological nursing care and cardiac rehabilitation exercise)based on that of control group;both groups continuously intervened for 5 days. SAS score and SDS score 1 day and 5 days after PCI,LVEF and LVEDV before PCI and 5 days after PCI,and 6-minute walking distance5 days after PCI were compared between the two groups,and incidence of adverse cardiovascular events was observed during intervention. Results(1)No statistically significant difference of SAS score or SDS score was found between the two groups1 day after PCI(P>0.05),while SAS score and SDS score in study group were statistically significantly lower than those in control group 5 days after PCI(P<0.05).(2)No statistically significant difference of LVEF or LVEDV was found between the two groups before PCI,nor was LVEDV 5 days after PCI(P>0.05);5 days after PCI,LVEF in study group was statistically significantly higher than that in control group,moreover 6-minute walking distance in study group was statistically significantly longer than that in control group(P<0.05).(3)No statistically significant difference of incidence of adverse cardiovascular events was found between the two groups during intervention(P>0.05). Conclusion Psychosomatic comprehensive nursing care can effectively relieve the negative emotion and improve the cardiac function in postoperative AMI patients complicated with left heart failure treated by PCI.
Objective To investigate the impact of psychosomatic comprehensive nursing care on negative emotion and cardiac function in postoperative acute myocardial infarction(AMI)patients complicated with left heart failure treated by PCI. Methods A total of 60 postoperative AMI patients complicated with left heart failure treated by PCI were selected in the Second People's Hospital of Huai'an from January 2017 to May 2018,and they were divided into control group and study group according to random number table method,with 30 cases in each group. Patients in control group received routine CCU nursing care,while patients in study group received psychosomatic comprehensive nursing care(including psychological nursing care and cardiac rehabilitation exercise)based on that of control group;both groups continuously intervened for 5 days. SAS score and SDS score 1 day and 5 days after PCI,LVEF and LVEDV before PCI and 5 days after PCI,and 6-minute walking distance5 days after PCI were compared between the two groups,and incidence of adverse cardiovascular events was observed during intervention. Results(1)No statistically significant difference of SAS score or SDS score was found between the two groups1 day after PCI(P>0.05),while SAS score and SDS score in study group were statistically significantly lower than those in control group 5 days after PCI(P<0.05).(2)No statistically significant difference of LVEF or LVEDV was found between the two groups before PCI,nor was LVEDV 5 days after PCI(P>0.05);5 days after PCI,LVEF in study group was statistically significantly higher than that in control group,moreover 6-minute walking distance in study group was statistically significantly longer than that in control group(P<0.05).(3)No statistically significant difference of incidence of adverse cardiovascular events was found between the two groups during intervention(P>0.05). Conclusion Psychosomatic comprehensive nursing care can effectively relieve the negative emotion and improve the cardiac function in postoperative AMI patients complicated with left heart failure treated by PCI.
引文
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[13]俞志红,朱利月,严婷,等.有氧运动8周对急性心肌梗死患者睡眠质量及情绪的影响[J].中华全科医学,2016,14(9):1439-1441.DOI:10.16766/j.cnki.issn.1674-4152.2016.09.004.
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[15]李盈,韦彬,李珍珍.“双心”护理干预对行经皮冠状动脉介入治疗的冠心病合并焦虑/抑郁患者的影响研究[J].实用心脑肺血管病杂志,2018,26(5):106-109.DOI:10.3969/j.issn.1008-5971.2018.05.027.
[16]黄子菁,陈康.急性心肌梗死合并抑郁症的相关性研究进展[J].实用心脑肺血管病杂志,2015,23(2):1-3.DOI:10.3969/j.issn.1008-5971.2015.02.001.
[17]杨月东,王敏健,王新东,等.补本解郁颗粒剂治疗冠心病经皮冠状动脉介入术后脾肾两虚型心绞痛的临床疗效[J].实用心脑肺血管病杂志,2018,26(3):75-78. DOI:10.3969/j.issn.1008-5971.2018.03.021.
[18]LEONA S,FRANKLINB A,COSTAF,etal.Cardiac rehabilitation and secondary prevention of coronary heart disease:an American Heart Association scientific statement from the Council on Clinical Cardiology(Subcommittee on Exercise,Cardiac Rehabilitation,and Prevention)and the Council on Nutrition,Physical Activity,and Metabolism(Subcommittee on Physical Activity),in collaboration with the American association of Cardiovascular and Pulmonary Rehabilitation[J].Circulation,2005,111(3):369-376.DOI:10.1161/01.CIR.0000151788.08740.5C.
[19]任斌,刘达瑾,孔永梅.我国心脏康复发展历程及心脏运动康复研究进展[J].实用心脑肺血管病杂志,2019,27(1):1-4.DOI:10.3969/j.issn.1008-5971.2019.01.001.
[2]中华医学会心血管病学分会介入心脏病学组,中国医师协会心血管内科医师分会血栓防治专业委员会,中华心血管病杂志编辑委员会.中国经皮冠状动脉介入治疗指南(2016)[J].中华心血管病杂志,2016,44(5):382-400.DOI:10.3760/cma.j.issn.0253-3758.2016.05.006.
[3]张雪燕,姚耿圳,郑朝阳,等.经皮冠状动脉介入术后脑出血三例报道及救治经验、教训[J].实用心脑肺血管病杂志,2019,27(3):111-114.
[4]陈丽娜.早期心脏康复运动治疗方案对急性非ST段抬高心肌梗死急诊PCI术后患者疗效研究[D].南京:南京中医药大学,2017.
[5]李森,姜亚芳.冠心病患者心脏康复依从性的影响因素及干预措施的研究进展[J].中华护理杂志,2008,43(5):454-456.DOI:10.3761/j.issn.0254-1769.2008.05.030.
[6]王俊红,杨巧芳,张振香.急性心肌梗死患者心脏康复依从性影响因素与干预措施的研究进展[J].护理学杂志,2017,32(23):103-105.DOI:10.3870/j.issn.1001-4152.2017.23.103.
[7]WHITE H D,THYGESEN K,ALPERT J S,et al.Republished:clinical implications of the third universal definition of myocardial infarction[J].Postgrad Med J,2014,90(1067):502-510.DOI:10.1136/postgradmedj-2012-302976rep.
[8]中华医学会心血管病学分会预防学组,中国康复医学会心血管病专业委员会.冠心病患者运动治疗中国专家共识[J].中华心血管病杂志,2015,43(7):575-588.DOI:10.3760/cma.j.issn.0253-3758.2015.07.004.
[9]苗婷,张新梅.延续性护理对急性心肌梗死患者PCI术后生活质量及焦虑、抑郁情绪的影响[J].海南医学,2018,29(14):2065-2067.DOI:10.3969/j.issn.1003-6350.2018.14.045.
[10]张海波,吴鹏,任平,等.血尿酸水平与高原中青年急性ST段抬高型心肌梗死患者冠状动脉病变程度及近期预后的关系研究[J].实用心脑肺血管病杂志,2017,25(10):24-27.DOI:10.3969/j.issn.1008-5971.2017.10.007.
[11]甄严杰,靳业辉,刘艳青,等.急性心肌梗死患者早期康复护理研究[J].河北医药,2012,34(3):466-467.DOI:10.3969/j.issn.1002-7386.2012.03.093.
[12]张院,宋小青,王丽丽.院外治疗依从性对急性心肌梗死患者长期预后及生存质量的影响研究[J].实用心脑肺血管病杂志,2017,25(2):30-33.DOI:10.3969/j.issn.1008-5971.2017.02.008.
[13]俞志红,朱利月,严婷,等.有氧运动8周对急性心肌梗死患者睡眠质量及情绪的影响[J].中华全科医学,2016,14(9):1439-1441.DOI:10.16766/j.cnki.issn.1674-4152.2016.09.004.
[14]沈艳.黛力新改善心肌梗死后合并焦虑、抑郁的慢性心力衰竭患者心功能的临床研究[D].苏州:苏州大学,2015.
[15]李盈,韦彬,李珍珍.“双心”护理干预对行经皮冠状动脉介入治疗的冠心病合并焦虑/抑郁患者的影响研究[J].实用心脑肺血管病杂志,2018,26(5):106-109.DOI:10.3969/j.issn.1008-5971.2018.05.027.
[16]黄子菁,陈康.急性心肌梗死合并抑郁症的相关性研究进展[J].实用心脑肺血管病杂志,2015,23(2):1-3.DOI:10.3969/j.issn.1008-5971.2015.02.001.
[17]杨月东,王敏健,王新东,等.补本解郁颗粒剂治疗冠心病经皮冠状动脉介入术后脾肾两虚型心绞痛的临床疗效[J].实用心脑肺血管病杂志,2018,26(3):75-78. DOI:10.3969/j.issn.1008-5971.2018.03.021.
[18]LEONA S,FRANKLINB A,COSTAF,etal.Cardiac rehabilitation and secondary prevention of coronary heart disease:an American Heart Association scientific statement from the Council on Clinical Cardiology(Subcommittee on Exercise,Cardiac Rehabilitation,and Prevention)and the Council on Nutrition,Physical Activity,and Metabolism(Subcommittee on Physical Activity),in collaboration with the American association of Cardiovascular and Pulmonary Rehabilitation[J].Circulation,2005,111(3):369-376.DOI:10.1161/01.CIR.0000151788.08740.5C.
[19]任斌,刘达瑾,孔永梅.我国心脏康复发展历程及心脏运动康复研究进展[J].实用心脑肺血管病杂志,2019,27(1):1-4.DOI:10.3969/j.issn.1008-5971.2019.01.001.