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中国临床研究英文版:2024,37(12):1945-1949
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基于老年综合评估的综合护理干预结合康复训练在急性心肌梗死PCI患者中的应用
(苏州大学附属第一医院心内科,江苏 苏州 215000)
Application of CGA-based comprehensive nursing intervention combined with rehabilitation training in PCI patients with acute myocardial infarction
(Department of Cardiology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, China)
摘要
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Received:January 24, 2024   Published Online:December 21, 2024
中文摘要: 目的 探讨基于老年综合评估(CGA)的综合护理干预结合康复训练对改善急性心肌梗死(AMI)经皮冠状动脉介入术(PCI)患者心肺功能、促进康复过程中的作用。方法 将2021年1月至2023年5月苏州大学附属第一医院收治的204例AMI患者纳为研究对象,按照随机数字表法分为常规组与CGA组,每组各102例。常规组给予常规护理与康复训练,CGA组给予基于CGA的综合护理干预与康复训练,比较两组干预前后心肺储备功能 [峰值耗氧量(VO2max)、无氧阈氧耗氧量(VO2AT)、二氧化碳通气当量斜率(VE/VCO2)]、心理状态 [采用汉密尔顿焦虑量表(HAMA)]、遵医行为、生活质量 [采用中国心血管病人生活质量问卷调查(CQQC)]及半年内主要心血管不良事件(MACE)发生率。结果 与干预前比较,干预后两组患者VO2max、VO2AT显著升高(P<0.01=,VE/VCO2显著下降(P<0.01),且干预后CGA组VO2max、VO2AT显著高于常规组(P<0.05),VE/VCO2显著低于常规组(P<0.05);干预后,两组HAMA评分显著下降(P<0.01),且CGA组显著低于常规组(P<0.01);干预后,CGA组均衡营养、戒除不良嗜好、健康锻炼3项遵医行为优于常规组(P=0.030、0.045、0.037);干预后,两组患者CQQC各项评分均显著上升(P<0.01),且CGA组显著高于常规组(P<0.01);两组患者半年内MACE发生率差异无统计学意义(1.96% vs 3.92%, χ2=0.687, P=0.407)。结论 基于CGA的综合护理干预结合康复训练可显著改善AMI患者PCI术后心肺储备功能,改善其负性情绪、遵医行为及生活质量。
Abstract:Objective To explore the application of comprehensive geriatric assessment (CGA)-based comprehensive nursing intervention combined with rehabilitation training in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). Methods A total of 204 patients with AMI admitted to the First Affiliated Hospital of Soochow University from January 2021 to May 2023 were included in the study. Patients were divided into routine group and CGA group by using the random number table method, with 102 cases in each group. The routine group was given routine nursing and rehabilitation training, while the CGA group was given CGA-based comprehensive nursing intervention and rehabilitation training. The cardiopulmonary reserve function [peak oxygen consumption (VO2max) and anaerobic threshold oxygen consumption (VO2AT), and carbon dioxide ventilation equivalent slope (VE/VCO2)], psychological status [using Hamilton Anxiety Scale (HAMA)], compliance behaviors and quality of life [China Questionnaire of Quality of Life in patients with cardiovascular diseases (CQQC)] before and after intervention and incidence rates of major adverse cardiovascular events (MACE) within half a year were compared between the two groups. Results After intervention, the VO2max and VO2AT in both groups were significantly increased (P<0.01) while the VE/VCO2 was significantly decreased (P<0.01). The VO2max and VO2AT in CGA group were significantly higher (P<0.05) while the VE/VCO2 was significantly lower compared to routine group (P=0.025). The HAMA scores in the two groups were reduced significantly after intervention (P<0.01), and the CGA group had significantly lower scores (P<0.01). After intervention, the three compliance behaviors of balanced nutrition, abstaining from bad habits and healthy exercise were significantly better in CGA group than those in routine group (P<0.05). The CQQC scores in the two groups after intervention were significantly increased (P<0.01), and the scores in CGA group were significantly higher (P<0.01). There was no statistical difference in the incidence increased of MACE between both groups within half a year (1.96% vs 3.92%, χ2=0.687, P=0.407). Conclusion CGA-based comprehensive nursing intervention combined with rehabilitation training can significantly improve the cardiopulmonary reserve function of AMI patients after PCI, and enhance the negative emotions, compliance behaviors and quality of life.
文章编号:     中图分类号:R473.5    文献标志码:B
基金项目:国家自然科学基金青年基金项目(81700305);江苏省高等学校基础科学(自然科学)研究面上项目(23KJB310023);苏州大学附属第一医院护理院级科研项目(HLYJ-2024-02)
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