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Received:December 01, 2023 Published Online:September 20, 2024
Received:December 01, 2023 Published Online:September 20, 2024
中文摘要: 目的 观察急性冠状动脉综合征(ACS)行经皮冠状动脉介入术(PCI)后早期心脏康复联合心理护理干预的应用效果。方法 选取2020年10月至2022年10月于淮安市第一人民医院行PCI治疗的ACS患者108例,经随机数字表法分为联合组(常规护理+早期心脏康复+心理护理干预)和对照组(常规护理),各54例。比较干预前后两组心功能、抑郁程度、自我管理能力、服药依从性、生活质量和主要不良心血管事件(MACE)发生。结果 干预后联合组左心室射血分数(LVEF)高于对照组,6 min步行距离(6MWD)长于对照组,N末端B型利尿钠肽原(NT-proBNP)低于对照组(P<0.05)。干预后联合组抑郁症状群量表患者健康问卷9(PHQ-9)评分低于对照组,冠心病自我管理行为量表(CSMS)、Morisky服药依从性量表(MMAS-8)评分均高于对照组(P<0.05)。干预后联合组躯体功能、心理功能、社会功能、物质生活评分均高于对照组(P<0.05)。联合组MACE发生率低于对照组(5.77%? vs 19.23%, χ2=4.308, P<0.038)。结论 早期心脏康复联合心理护理干预可改善ACS患者行PCI后心功能、心理状态、自我管理能力、服药依从性及生活质量,减少MACE。
Abstract:Objective To observe the application effects of early cardiac rehabilitation combined with psychological care intervention after percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS). Methods A total of 108 ACS patients who underwent PCI at the Huai'an First People's Hospital from October 2020 to October 2022 were selected. They were randomly divided into the combined group (routine care + early cardiac rehabilitation + psychological nursing intervention) and the control group (routine care), with 54 patients in each group. The study compared the changes in cardiac function, depression levels, self-management ability, medication adherence, quality of life, and major adverse cardiovascular events (MACE) before and after intervention. Results After intervention, the left ventricular ejection fraction (LVEF) in the combined group was higher than that in the control group. The 6-minute walk distance (6MWD) was longer, and the N-terminal pro-B-type natriuretic peptide (NT-proBNP) was lower in the combined group compared to the control group (P<0.05). The combined group showed lower scores on the Patient Health Questionnaire-9 (PHQ-9) compared to the control group. Scores of the Coronary Heart Disease Self-Management Scale (CSMS) and Morisky Medication Adherence Scale-8 (MMAS-8) were higher in the combined group (P<0.05). Physical function, psychological function, social function, and material life state scores were higher in the combined group than in the control group (P<0.05). The incidence of MACE in the combined group was lower than that in the control group (5.77%? vs 19.23%, χ2=4.308, P=0.038). Conclusion Early cardiac rehabilitation combined with psychological care intervention can improve cardiac function, mental status, self-management ability, medication adherence, and quality of life in ACS patients after PCI, reducing the occurrence of MACE.
keywords: Acute coronary syndrome Percutaneous coronary intervention Early cardiac rehabilitation Psychological care Six-minute walk test Major adverse cardiovascular events Left ventricular ejection fraction
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