摘要
目的探讨基于鱼骨图分析法的双心干预模式对冠状动脉支架植入术(PCI)患者急性应激障碍(ASD)及不良事件的影响作用。方法选取2018年1月至2020年5月该院PCI患者102例作为研究对象,根据入院建档排序以1∶1原则平均分为两组,每组各51例。对照组患者接受常规护理,观察组患者对照组基础上接受基于鱼骨图分析法的双心干预模式。比较两组患者干预前后斯坦福急性应激反应问卷(SASRQ)、术前及术后心脏功能(心排血量、心脏指数)及术后并发症和舒适度、主要不良心血管事件(MACE)发生率。结果观察组患者冠心病监护病房(CCU)停留时间明显短于对照组(P<0.001);干预后观察组患者SASRQ各维度评分均明显低于对照组(P<0.001)。与术前比较,术后1、3 d及出CCU时两组患者心排血量、心脏指数明显升高(P<0.05);术后1、3 d两组患者心排血量、心脏指数比较差异无统计学意义(P>0.05);但出CCU时观察组患者心排血量明显高于对照组(P<0.001),而两组患者心脏指数比较差异无统计学意义(P>0.05)。观察组腰酸背疼、烦躁失眠发生率低于对照组(P<0.001),且观察组MACE发生率明显低于对照组(1.96%vs.15.69%,P=0.001)。结论基于鱼骨图分析法的双心干预模式能减轻PCI患者ASD,提高心脏泵血功能,并可降低不良事件风险,减轻术后腰背疼痛等不适症状。
Objective To explore the effect of bicardiac intervention model based on the fishbone diagram analysis on acute stress disorder(ASD)and adverse events in the patients undergoing coronary stenting(PCI).Methods A total of 102 patients with PCI in this hospital from January 2018 to May 2020 were selected as the research subjects and evenly divided into the two groups on the principle of 1:1 according to the filing order of admission,51 cases in each group.The control group received the routine nursing.On this basis,the observation group received the double heart intervention mode based on the fishbone diagram analysis.The scores of the Stanford Acute Stress Response Questionnaire(SASRQ),preoperative and postoperative cardiac function(cardiac output,cardiac index),postoperative complications and comfort,and the incidence rate of major adverse cardiovascular events(MACE)were compared between the two groups.Results The stay time of coronary heart care unit(CUU)in the observation group was shorter than that in the control group(P<0.001);after intervention,the scores of various SASRQ dimensions in the observation group were significantly lower than those in the control group(P<0.001);the cardiac output and cardiac index on postoperative 1,3 d and out of CCU in the two groups were significantly increased compared with those before operation(P<0.05),but there was no statistically significant difference in the cardiac output and cardiac index on postoperative 1,3 d between the two groups(P>0.05);the cardiac output when out from CCU in the observation group was significantly higher than that in the control group(P<0.001),but there was no statistically significant difference in the cardiac index between the two groups(P>0.05);the incidence rates of soreness of waist,backache,irritability and insomnia in the observation group were lower than those in the control group(P<0.001),moreover the incidence rate of MACE in the observation group was significantly lower than that in the control group(1.96%vs.15.69%,P=0.001).Conclusion The bicardiac intervention model based on the fishbone diagram analysis can reduce ASD,increase the cardiac pumping function,reduce the risk of adverse events and alleviate the discomfort symptoms such as postoperative lumbago and back pain in the patients with PCI.
作者
张宁
吕向妮
付文
李云熙
俞世强
ZHANG Ning;LYU Xiangni;FU Wen;LI Yunxi;YU Shiqiang(Cardiovascular Surgical Care Unit,First Affiliated Hospital of Air Force Military Medical University,Xi′an,Shaanxi 710000,China)
出处
《重庆医学》
CAS
2022年第11期1807-1811,1817,共6页
Chongqing medicine
基金
国家重点研发计划项目(2016YFC1301900)。
关键词
鱼骨图分析法
双心干预模式
冠状动脉支架植入术
急性应激障碍
不良事件
fishbone diagram analysis method
bicardiac mode intervention
percutaneous coronary intervention
acute stress disorder
adverse events
