摘要
目的探讨基于计划外再入院风险模型(LACE)干预计划在急性心肌梗死(AMI)合并心源性休克(CS)患者经皮冠状动脉介入治疗(PCI)后康复中的应用效果。方法选择2019年1月至2020年12月在天津市人民医院接受PCI治疗的93例AMI合并CS患者,根据不同护理干预方法分为LACE干预组(46例)和常规干预组(47例)。常规干预组开展常规护理干预,包括药物护理、饮食护理、心理护理、健康宣教及电话随访;LACE干预组则先对患者进行LACE风险评估,然后根据LACE指数评分制定相关干预措施,包括强化风险认知、生活行为、日常生活能力、自我照护能力、健康恢复情况以及健康需求等。两组干预随访时间均为3个月。比较两组干预前及干预3个月后心功能变化,心脏不良事件发生率及再入院率,干预后自我管理能力,以及干预前后生活质量水平的差异。结果干预前两组患者心功能和生活质量水平差异均无统计学意义。干预3个月后,两组心功能和生活质量水平均较干预前明显改善,且LACE干预组左室射血分数(LVEF)明显高于常规干预组(0.533±0.076比0.492±0.072,P<0.05),左室舒张期末内径(LVEDD)明显小于常规干预组(mm:47.09±7.01比53.23±7.15,P<0.01),世界卫生组织生存质量测定量表简表(WHOQOL-BREF)评分亦明显高于常规干预组(分:66.32±6.19比55.79±7.26,P<0.01)。LACE干预组干预后冠心病自我管理量表(CSMS)中各项自我管理能力评分均明显高于常规干预组〔不良嗜好(分):17.37±3.24比14.21±2.73,症状(分):14.82±3.11比10.56±2.65,情绪认知(分):16.17±2.83比12.95±2.41,急救(分):11.85±1.94比10.62±1.56,疾病知识(分):15.58±2.73比12.68±2.61,日常生活(分):17.80±2.61比14.33±2.36,治疗依从性(分):11.47±1.84比8.56±1.23,均P<0.01〕,且心脏不良事件发生率及再入院率均明显低于常规干预组(10.87%比29.79%,4.35%比17.02%,均P<0.05)。结论基于LACE风险模型的干预计划可有�
Objective To study and analyze the application effect of intervention plan based on unplanned readmission risk model(LACE)in the rehabilitation of patients with acute myocardial infarction(AMI)complicated with cardiac shock(CS)after percutaneous coronary intervention(PCI).Methods Ninety-three patients with AMI complicated with CS who received PCI in Tianjin Union Medical Center from January 2019 to December 2020 were enrolled.The patients were divided into LACE intervention group(n=46)and routine intervention group(n=47)according to the different nursing intervention methods.The patients in the routine intervention group received routine interventions,including drug care,diet care,psychological care,health education and telephone follow-up,while those in the LACE intervention group were assessed for the risk of LACE,and then intervention measures were formulated according to the score of LACE index,including strengthening risk awareness,life behavior,daily life ability,self-care ability,health recovery and health needs.The follow-up period in both groups was 3 months.The changes of cardiac function,incidence of adverse cardiac events,readmission rate,self-management ability after intervention and quality of life level before and after intervention were compared between the two groups.Results There was no significant difference in cardiac function or quality of life before intervention between the two groups.After intervention for 3 months,the cardiac function and quality of life in the two groups were improved as compared with those before intervention.The left ventricular ejection fraction(LVEF)in the LACE intervention group was significantly higher than that in the routine intervention group(0.533±0.076 vs.0.492±0.072,P<0.05),the left ventricular end diastolic diameter(LVEDD)was significantly lower than that in the routine intervention group(mm:47.09±7.01 vs.53.23±7.15,P<0.01),and the World Health Organization Quality of Life-brief(WHOQOL-BREF)score was also significantly higher than that in the routine int
作者
王素娟
任越蓉
傅晓惠
陈浩
马宏文
Wang Sujuan;Ren Yuerong;Fu Xiaohui;Chen Hao;Ma Hongwen(Department of Interventional Catheter Room,Tianjin Union Medical Center,Tianjin 300121,China)
出处
《中华危重病急救医学》
CAS
CSCD
北大核心
2021年第4期487-490,共4页
Chinese Critical Care Medicine
