摘要
目的探讨冠状动脉搭桥术后患者症状群轨迹的变化,分析与术后症状轨迹变化相关的危险因素。方法选择行冠状动脉搭桥术患者132例,通过病历和随访获得患者术前,术后1周、6周和3个月的症状评分和一般资料。采用Memorial心力衰竭症状评估量表评估每个症状,潜类别增长模型绘制症状群轨迹图并以多元逻辑回归分析评估影响症状的危险因素。结果132例患者Memorial心力衰竭症状评估量表评价显示,术前心绞痛、睡眠障碍、呼吸困难、疲劳、抑郁及焦虑症状评分≥2分,其他26个症状评分<2分。对术前评分≥2分的6个症状进行轨迹研究,确定了2~3种不同程度的轨迹。男性、年龄≥65岁、BMI≥27、吸烟、饮酒、长ICU住院时间、更少的血管重建数、非体外循环冠状动脉搭桥术以及缺乏规律运动与症状严重趋势之间具有相关性。结论冠状动脉搭桥术后患者心绞痛、睡眠障碍、呼吸困难、疲劳、抑郁、焦虑症状在术后3个月内总体逐渐缓解。
Objective To study the trajectory changes of symptom cluster for patients after coronary artery bypass grafting and analyze its related risk factors.Method Choose 132 cases of patients undergoing coronary artery bypass grafting and collect symptom scores and general information of patients from medical records and follow-up interview before surgery and 1 week,6 weeks,3 months after surgery.Evaluate each symptom by Memorial Symptom Assessment Scale-Heartfailure(MSAS-HF).Draw symptoms cluster trajectories by latent class growth model.Analyze the related risk factors of severity degree by multivariate logistic regression.Result MSAS-HF of 132 patients shows that preoperative and postoperative scores on angina pectoris,sleep disorder,dyspnea,fatigue,depression and anxiety are higher than or equal to 2 and score on other 26 symptoms are lower than 2.Study the trajectory of 6 symptoms with score higher than or equal to 2 and confirm 2~3 trajectories of different levels.Male,age≥65,BMI≥27,smoking,drinking,long ICU hospitalization time,less revascularization,off-pump coronary artery bypass grafting,and lack of regular exercise have positive correlation with symptom exacerbation.Conclusion Symptoms mainly influencing patients’quality of life after coronary artery bypass grafting are angina pectoris,sleep disorder,dyspnea,fatigue,depression and anxiety.All symptoms are generally relieving 3 months after surgery.
作者
魏小勇
姚春月
Wei Xiaoyong;Yao Chunyue(The Second Affiliated Hospital Zhejiang University School of Medicine,Hangzhou Zhejiang 310009,China;The Affiliated Hospital of Hangzhou Normal University,Hangzhou Zhejiang 310015,China)
出处
《护理与康复》
2021年第1期1-7,共7页
Journal of Nursing and Rehabilitation
关键词
冠状动脉搭桥术
症状轨迹
影响因素
护理干预
coronary artery bypass grafting
symptom trajectory
influencing factor
nursing intervention
