全程护理模式对冠心病合并糖尿病患者PCI术后生活质量及心血管不良事件的影响
|
摘要
目的探讨全程护理模式对冠心病合并糖尿病患者经皮冠状动脉介入(PCI)术后生活质量及心血管不良事件的影响。方法选择2017年1～12月期间孝感市中心医院心内二科收治的46例冠心病合并2型糖尿病患者为研究对象,根据随机数表法将患者分为观察组和对照组,每组23例,所有患者均接受PCI治疗,对照组予常规护理,观察组则应用全程护理模式,干预时间为6个月。干预前后采用SF-36量表对两组患者的生活质量进行评价,包括生理健康总评分(PCS)和心理健康总评分(MCS),记录主要心血管不良事件(MACE)的发生情况。结果干预前,观察组患者的SF-36量表总分及PCS、MCS得分分别为(60.4±7.2)分、(59.1±6.7)分、(61.4±6.6)分,与对照组的(59.8±6.3)分、(58.9±5.2)分、(61.3±5.7)分比较,差异均无统计学意义(P>0.05);干预后,观察组患者的上述得分分别为(67.5±7.9)分、(66.4±7.2)分、(68.6±8.1)分,明显高于干预前,且高于对照组的(61.8±5.6)分、(61.2±6.3)分、(62.4±5.6)分,差异均有统计学意义(P<0.05);观察组患者的MACE发生率为13.04%,明显低于对照组的30.43%,差异有统计学意义(P<0.05)。结论全程护理模式应用于冠心病合并糖尿病患者可以明显降低患者主要心血管不良事件的发生风险,提高患者的生活质量。
Objective To investigate the effect of whole-course nursing mode on quality of life and adverse cardiovascular events after percutaneous coronary intervention(PCI) in patients with coronary heart disease complicated with diabetes mellitus. Methods A total of 46 patients with coronary heart disease complicated with type 2 diabetes treated in the Second Department of Cardiology at Xiaogan Central Hospital from January 2017 to December 2017 were selected and divided into an observation group and a control group according to the random number table method, with23 cases in each group. Based on PCI, the control group received routine care, and the observation group applied the whole-course nursing; the intervention time were both 6 months. The quality of life of the two groups was evaluated by the SF-36 scale before and after the intervention, including Physical and Mental Health Composite Scores(PCS &MCS). The occurrence of major cardiovascular adverse events(MACE) was recorded. Results Before the intervention,the total scores of the SF-36 scale and PCS & MCS in the observation group were respectively 60.4±7.2, 59.1±6.7, and61.4±6.6; compared with the corresponding 59.8±6.3, 58.9±5.2, and 61.3±5.7 in the control group(P>0.05). After the intervention, the above scores in the observation group were respectively 67.5±7.9, 66.4±7.2, and 68.6±8.1, which were significantly higher than those before the intervention, and higher than the corresponding 61.8±5.6, 61.2±6.3, and 62.4±5.6 in the control group; all differences were statistically significant(P<0.05). The incidence of MACE in the observation group was 13.04%, which was significantly lower than 30.43% in the control group, and the difference was statistically significant(P<0.05). Conclusion The whole-course nursing mode applied to patients with coronary heart disease complicated with diabetes mellitus can significantly reduce the risk of major cardiovascular adverse events and improve the quality of life of patients.
Objective To investigate the effect of whole-course nursing mode on quality of life and adverse cardiovascular events after percutaneous coronary intervention(PCI) in patients with coronary heart disease complicated with diabetes mellitus. Methods A total of 46 patients with coronary heart disease complicated with type 2 diabetes treated in the Second Department of Cardiology at Xiaogan Central Hospital from January 2017 to December 2017 were selected and divided into an observation group and a control group according to the random number table method, with23 cases in each group. Based on PCI, the control group received routine care, and the observation group applied the whole-course nursing; the intervention time were both 6 months. The quality of life of the two groups was evaluated by the SF-36 scale before and after the intervention, including Physical and Mental Health Composite Scores(PCS &MCS). The occurrence of major cardiovascular adverse events(MACE) was recorded. Results Before the intervention,the total scores of the SF-36 scale and PCS & MCS in the observation group were respectively 60.4±7.2, 59.1±6.7, and61.4±6.6; compared with the corresponding 59.8±6.3, 58.9±5.2, and 61.3±5.7 in the control group(P>0.05). After the intervention, the above scores in the observation group were respectively 67.5±7.9, 66.4±7.2, and 68.6±8.1, which were significantly higher than those before the intervention, and higher than the corresponding 61.8±5.6, 61.2±6.3, and 62.4±5.6 in the control group; all differences were statistically significant(P<0.05). The incidence of MACE in the observation group was 13.04%, which was significantly lower than 30.43% in the control group, and the difference was statistically significant(P<0.05). Conclusion The whole-course nursing mode applied to patients with coronary heart disease complicated with diabetes mellitus can significantly reduce the risk of major cardiovascular adverse events and improve the quality of life of patients.
引文
[1]张巧,时立新,彭年春,等.贵阳城区糖尿病、糖尿病前期流行病学调查及危险因素分析[J].中华内分泌代谢杂志,2013,29(2):144-147.
[2]李慧华,吕慧,陆建灿,等.糖尿病合并冠状动脉粥样硬化性心脏病患者冠状动脉病变程度与糖化血红蛋白及胆红素水平相关性分析[J].上海交通大学学报(医学版),2016,36(2):233-236,242.
[3]曾小曼,余再新,王栋,等.经皮冠状动脉介入治疗缺血性心肌病合并严重心功能不全患者疗效观察[J].海南医学,2017,28(3):475-477.
[4]刘晓宇,袁托亚,王悦喜,等.冠心病合并2型糖尿病患者临床表现及冠状动脉病变特点分析[J].疑难病杂志,2014,13(2):114-117.
[5]舒荣文,孔庆军,钟勇,等.冠状动脉造影金标准与临床常规诊断冠心病差异性比较研究[J].海军医学杂志,2015,36(4):311-314.
[6]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中华糖尿病杂志,2014,6(7):447-498.
[7]任晓晖,刘朝杰,李宁秀,等.用SF-36量表评价慢性病患者的生命质量[J].华西医科大学学报,2001,32(2):250-253.
[8]陈伟伟,高润霖,刘力生,等.《中国心血管病报告2015》概要[J].中国循环杂志,2016,31(6):624-632.
[9]HU DY,PAN CY,YU JM,et al.The relationship between coronary artery disease and abnormal glucose regulation in China:the China Heart Survey[J].Eur Heart J,2006,27(21):2573-2579.
[10]梁东亮,李小鹰,王林,等.老年冠心病合并糖尿病及高血压患者降压达标和降压药物使用情况的现况调查[J].中华医学杂志,2015,95(33):2709-2714.
[11]党庆莲,刘瑞.急诊介入手术治疗老年急性心肌梗死的近期疗效及其对患者血清炎症因子的影响[J].海南医学,2016,27(13):2085-2087.
[12]方圆圆,郑丽丽.2型糖尿病血糖变异性与冠状动脉狭窄程度的关系[J].中华内分泌代谢杂志,2014,30(2):96-100.
[13]陆新芬,严忠慧.综合护理干预对冠心病患者生活质量的影响观察[J].中国医药导报,2014,11(11):128-131.
[14]白璐,胡传来,韦学萍,等.延续性护理干预对提高冠心病介入术后患者自我管理水平的效果[J].安徽医学,2016,37(8):1037-1040.
[15]周莉莉.社区糖尿病高危人群实施延伸护理的意义探究[J].中国实用医药,2015,10(31):277-278.
[2]李慧华,吕慧,陆建灿,等.糖尿病合并冠状动脉粥样硬化性心脏病患者冠状动脉病变程度与糖化血红蛋白及胆红素水平相关性分析[J].上海交通大学学报(医学版),2016,36(2):233-236,242.
[3]曾小曼,余再新,王栋,等.经皮冠状动脉介入治疗缺血性心肌病合并严重心功能不全患者疗效观察[J].海南医学,2017,28(3):475-477.
[4]刘晓宇,袁托亚,王悦喜,等.冠心病合并2型糖尿病患者临床表现及冠状动脉病变特点分析[J].疑难病杂志,2014,13(2):114-117.
[5]舒荣文,孔庆军,钟勇,等.冠状动脉造影金标准与临床常规诊断冠心病差异性比较研究[J].海军医学杂志,2015,36(4):311-314.
[6]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中华糖尿病杂志,2014,6(7):447-498.
[7]任晓晖,刘朝杰,李宁秀,等.用SF-36量表评价慢性病患者的生命质量[J].华西医科大学学报,2001,32(2):250-253.
[8]陈伟伟,高润霖,刘力生,等.《中国心血管病报告2015》概要[J].中国循环杂志,2016,31(6):624-632.
[9]HU DY,PAN CY,YU JM,et al.The relationship between coronary artery disease and abnormal glucose regulation in China:the China Heart Survey[J].Eur Heart J,2006,27(21):2573-2579.
[10]梁东亮,李小鹰,王林,等.老年冠心病合并糖尿病及高血压患者降压达标和降压药物使用情况的现况调查[J].中华医学杂志,2015,95(33):2709-2714.
[11]党庆莲,刘瑞.急诊介入手术治疗老年急性心肌梗死的近期疗效及其对患者血清炎症因子的影响[J].海南医学,2016,27(13):2085-2087.
[12]方圆圆,郑丽丽.2型糖尿病血糖变异性与冠状动脉狭窄程度的关系[J].中华内分泌代谢杂志,2014,30(2):96-100.
[13]陆新芬,严忠慧.综合护理干预对冠心病患者生活质量的影响观察[J].中国医药导报,2014,11(11):128-131.
[14]白璐,胡传来,韦学萍,等.延续性护理干预对提高冠心病介入术后患者自我管理水平的效果[J].安徽医学,2016,37(8):1037-1040.
[15]周莉莉.社区糖尿病高危人群实施延伸护理的意义探究[J].中国实用医药,2015,10(31):277-278.