预先激活心导管室流程联合心理认知干预对急性心肌梗死患者再灌注时间和家属焦虑情绪的影响
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摘要
目的探讨预先激活心导管室流程联合心理认知干预对急性心肌梗死患者再灌注时间和家属焦虑情绪的影响。方法选取2018年1月—2019年2月濉溪县医院收治的50例行经皮冠状动脉介入治疗(PCI)的急性心肌梗死患者,25例患者采用常规流程纳入对照组,25例患者采用预先激活心导管室流程联合心理认知干预纳入观察组。比较2组患者再灌注时间、家属焦虑评分、家属满意度,以及PCI成功率、院内死亡率、并发症发生率。结果观察组心电图-导管室时间、门-导管室时间和门-球囊时间均短于对照组(均P<0.05),门-心电图时间和导管室-球囊时间2组比较差异无统计学意义(P>0.05)。观察组家属焦虑评分低于对照组,家属满意度评分高于对照组(均P<0.05)。观察组PCI成功率为92.00%,高于对照组的68.00%(均P<0.05)。观察组院内死亡率为0.00%,对照组为12.00%。观察组并发症发生率为28.00%,对照组为40.00%,2组院内死亡率、并发症发生率差异无统计学意义(均P>0.05)。结论对行PCI的急性心肌梗死患者开展预先激活心导管室流程,能明显缩短再灌注时间,提高抢救效率。联合心理认知干预可以有效减轻家属的焦虑情绪,提高家属满意度,符合以人为本的优质服务理念。
Objective To investigate the effects of pre-activated cardiac catheterization process and mental cognition intervention on reperfusion time of patients with acute myocardial infarction and anxiety of family members. Methods Fifty patients with acute myocardial infarction who underwent percutaneous coronary intervention(PCI) were selected. Of them, 25 cases were given routine process and included in the control group. The other 25 cases were given pre-activated cardiac catheterization process and mental cognition intervention and included in the observation group. The reperfusion time, anxiety scores of family members, satisfaction of family members, PCI success rate, in-hospital mortality and incidence of complications were compared between the two groups. Results The electrocardiogram-catheter chamber time, portal-catheter chamber time and portal-balloon time in the observation group were shorter than those in the control group(all P<0.05). There was no significant difference in portal-electrocardiogram time or catheter chamber-balloon time between the two groups(P>0.05). The anxiety scores of family members in the observation group were lower than those in the control group(all P<0.05), while satisfaction score of family members was higher than that in the control group(all P<0.05). The success rate of PCI in the observation group was was higher than that in the control group(92.00% vs. 68.00%), P<0.05. The in-hospital mortality of the observation group was was lower than that of the control group(0.00% vs. 12.00%). The incidence of complications in the observation group was lower than that in the control group(28.00% vs. 40.00%). There was no difference in the in-hospital mortality and complication rate between the two groups(all P>0.05). Conclusion Conducting pre-activated cardiac catheterization process can significantly shorten reperfusion time and improve rescue efficiency for patients with acute myocardial infarction undergoing PCI. Its combination with mental cognition intervention can effectively reduce anxiety and improve satisfaction of family members, which meets the people-oriented quality service concept.
Objective To investigate the effects of pre-activated cardiac catheterization process and mental cognition intervention on reperfusion time of patients with acute myocardial infarction and anxiety of family members. Methods Fifty patients with acute myocardial infarction who underwent percutaneous coronary intervention(PCI) were selected. Of them, 25 cases were given routine process and included in the control group. The other 25 cases were given pre-activated cardiac catheterization process and mental cognition intervention and included in the observation group. The reperfusion time, anxiety scores of family members, satisfaction of family members, PCI success rate, in-hospital mortality and incidence of complications were compared between the two groups. Results The electrocardiogram-catheter chamber time, portal-catheter chamber time and portal-balloon time in the observation group were shorter than those in the control group(all P<0.05). There was no significant difference in portal-electrocardiogram time or catheter chamber-balloon time between the two groups(P>0.05). The anxiety scores of family members in the observation group were lower than those in the control group(all P<0.05), while satisfaction score of family members was higher than that in the control group(all P<0.05). The success rate of PCI in the observation group was was higher than that in the control group(92.00% vs. 68.00%), P<0.05. The in-hospital mortality of the observation group was was lower than that of the control group(0.00% vs. 12.00%). The incidence of complications in the observation group was lower than that in the control group(28.00% vs. 40.00%). There was no difference in the in-hospital mortality and complication rate between the two groups(all P>0.05). Conclusion Conducting pre-activated cardiac catheterization process can significantly shorten reperfusion time and improve rescue efficiency for patients with acute myocardial infarction undergoing PCI. Its combination with mental cognition intervention can effectively reduce anxiety and improve satisfaction of family members, which meets the people-oriented quality service concept.
引文
[1] 高晓津,杨进刚,杨跃进,等.中国急性心肌梗死患者心血管危险因素分析[J].中国循环杂志,2015,30(3):206-210.
[2] KRISTENSEN S D,LAUT K G,FAJADET J,et al.Reperfusion therapy for ST elevation acute myocardial infarction 2010/2011:current status in 37 ESC countries[J].Eur Heart J,2014,35(29):1957-1970.
[3] CUNG T T,MOREL O,CAYLA G,et al.Cyclosporine before PCI in patients with acute myocardial infarction[J].N Engl J Med,2015,373(11):1021-1031.
[4] SIMON E L,GRIFFIN P,MEDEPALLI K,et al.Door-to-balloon times from freestanding emergency departments meet ST-segment elevation myocardial infarction reperfusion guidelines[J].J Emerg Med,2014,46(5):734-740.
[5] DAVIS R C.New criteria for diagnosis of myocardial infarction[J].BMJ,2015,326(7381):134-135.
[6] SUN Z,LIU H,JIAO L,et al.Reliability and validity of hospital anxiety and depression scale[J].Chin J Clinic,2017,11(2):198-201.
[7] 邱茹洁,张存泰,徐承义,等.老年冠心病患者冠状动脉慢性完全闭塞病变介入治疗及预后分析[J].内科急危重症杂志,2015,21(1):12-15.
[8] 赵豫鄂,何细飞,张丽萍,等.急性ST段抬高型心肌梗死患者进门-球囊时间延迟分布调查分析[J].护理学杂志,2017,32(23):34-36.
[9] 文艳飞,龚志华,向定成.利用现代化信息手段逐步优化导管室启动流程[J].中国数字医学,2015,10(9):43-44.
[10] 王国忠,华琦,柳子静,等.基层医院通过微信院前激活导管室对急性ST段抬高型心肌梗死病人再灌注时间的影响[J].首都医科大学学报,2017,38(3):391-396.
[11] 徐荣,郭金成,陈文明,等.基于微信平台区域协同救治对急性ST段抬高性心肌梗死介入治疗再灌注时间的影响[J].中国医刊,2016,51(6):46-49.
[12] ASTARCIOGLU M A,SEN T,KILIT C,et al.Time-to-reperfusion in STEMI undergoing interhospital transfer using smartphone and WhatsApp messenger[J].Am J Emerg Med,2015,33(10):1382-1384.
[13] 郭瑞威,杨丽霞,木丽华,等.“一键式启动导管室”在急性心肌梗死直接PCI中的应用研究[J].中国循证心血管医学杂志,2016,8(1):37-39.
[14] 裘毅钢,李田昌,陈宇,等.“急救车-导管室”模式对急性心肌梗死患者开通血管时间和左室功能的影响[J].中国循证心血管医学杂志,2015,7(1):76-79.
[15] 王国忠,华琦,柳子静,等.基层医院通过微信院前激活导管室对急性ST段抬高型心肌梗死病人再灌注时间的影响[J].首都医科大学学报,2017,38(3):391-396.
[16] KAWAKAMI S,TAHARA Y,NOGUCHI T,et al.Time to reperfusion in st-segment elevation myocardial infarction patients with vs.Without pre-hospital mobile telemedicine 12-lead electrocardiogram transmission[J].Circ J,2016,80(7):1624-1633.
[2] KRISTENSEN S D,LAUT K G,FAJADET J,et al.Reperfusion therapy for ST elevation acute myocardial infarction 2010/2011:current status in 37 ESC countries[J].Eur Heart J,2014,35(29):1957-1970.
[3] CUNG T T,MOREL O,CAYLA G,et al.Cyclosporine before PCI in patients with acute myocardial infarction[J].N Engl J Med,2015,373(11):1021-1031.
[4] SIMON E L,GRIFFIN P,MEDEPALLI K,et al.Door-to-balloon times from freestanding emergency departments meet ST-segment elevation myocardial infarction reperfusion guidelines[J].J Emerg Med,2014,46(5):734-740.
[5] DAVIS R C.New criteria for diagnosis of myocardial infarction[J].BMJ,2015,326(7381):134-135.
[6] SUN Z,LIU H,JIAO L,et al.Reliability and validity of hospital anxiety and depression scale[J].Chin J Clinic,2017,11(2):198-201.
[7] 邱茹洁,张存泰,徐承义,等.老年冠心病患者冠状动脉慢性完全闭塞病变介入治疗及预后分析[J].内科急危重症杂志,2015,21(1):12-15.
[8] 赵豫鄂,何细飞,张丽萍,等.急性ST段抬高型心肌梗死患者进门-球囊时间延迟分布调查分析[J].护理学杂志,2017,32(23):34-36.
[9] 文艳飞,龚志华,向定成.利用现代化信息手段逐步优化导管室启动流程[J].中国数字医学,2015,10(9):43-44.
[10] 王国忠,华琦,柳子静,等.基层医院通过微信院前激活导管室对急性ST段抬高型心肌梗死病人再灌注时间的影响[J].首都医科大学学报,2017,38(3):391-396.
[11] 徐荣,郭金成,陈文明,等.基于微信平台区域协同救治对急性ST段抬高性心肌梗死介入治疗再灌注时间的影响[J].中国医刊,2016,51(6):46-49.
[12] ASTARCIOGLU M A,SEN T,KILIT C,et al.Time-to-reperfusion in STEMI undergoing interhospital transfer using smartphone and WhatsApp messenger[J].Am J Emerg Med,2015,33(10):1382-1384.
[13] 郭瑞威,杨丽霞,木丽华,等.“一键式启动导管室”在急性心肌梗死直接PCI中的应用研究[J].中国循证心血管医学杂志,2016,8(1):37-39.
[14] 裘毅钢,李田昌,陈宇,等.“急救车-导管室”模式对急性心肌梗死患者开通血管时间和左室功能的影响[J].中国循证心血管医学杂志,2015,7(1):76-79.
[15] 王国忠,华琦,柳子静,等.基层医院通过微信院前激活导管室对急性ST段抬高型心肌梗死病人再灌注时间的影响[J].首都医科大学学报,2017,38(3):391-396.
[16] KAWAKAMI S,TAHARA Y,NOGUCHI T,et al.Time to reperfusion in st-segment elevation myocardial infarction patients with vs.Without pre-hospital mobile telemedicine 12-lead electrocardiogram transmission[J].Circ J,2016,80(7):1624-1633.