摘要
目的 观察基于循证医学的围术期风险管理对心脏重症监护室(CCU)心律失常患者射频消融术效果的影响。方法 本研究为前瞻性研究,选择南阳市第一人民医院2020年5月至2023年3月收治的98例CCU心律失常患者为研究对象,以计算机分组法将其分为常规组和试验组,各49例。2组均接受射频消融术治疗,常规组实施常规围术期管理,试验组实施基于循证医学的围术期风险管理,比较2组患者心理状态、心功能改善情况、康复进程及术后并发症发生情况。结果 在不同管理模式下,常规组的汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)评分分别为(21±5)分、(24±5)分,均低于常规组[(24±5)分、(27±5)分];常规组的左心室射血分数(LVEF)(60±10)%高于常规组(55±10)%,左心室舒张末期内径(LVDD)(40±10)mm低于常规组(45±10)mm;常规组的CCU转出时间、下床活动时间、胃肠功能恢复时间、住院时间分别为(50.2±10.2)h、(1.2±0.3)d、(24.1±5.2)h、(8.5±1.5)d,均低于常规组[(55.3±10.8)h、(2.2±0.8)d、(27.3±5.2)h、(10.2±2.3)d];常规组的并发症发生率8%(4/49)低于常规组20%(10/49),差异均具有统计学意义(P<0.05)。结论 基于循证医学的围术期风险管理能改善CCU心律失常患者的不良情绪,对增强患者手术疗效、加快术后康复进程并降低手术风险均有积极意义。
Objective To observe the impact of evidence-based medicine-based perioperative risk management on the effectiveness of radiofrequency ablation in coronary care unit(CU)arrhythmia patients.Methods This study is a prospective study that selected 98 CCU arrhythmia patients admitted from May 2020 to March 2023 as the study subjects.They were divided into a conventional group(49 cases)and an experimental group(49 cases)using the computer grouping method.Both groups received radiofrequency ablation treatment,with the conventional group implementing routine perioperative management and the experimental group implementing evidence-based medicine-based perioperative risk management.The psychological status,cardiac function improvement,rehabilitation progress,and postoperative complications of the two groups of patients were compared.Results Under different management modes,the HAMA and HAMD scores of the experimental group were(21±5)and(24±5),respectively,which were lower than those of the conventional group[(24+5)and(27±5)].The left ventricular ejection fraction(LVEF)(60+10)%of the experimental group was higher than that of the conventional group(55+10)%,and the left ventricular enddiastolic dimension(LVDD)(40+10)mm was lower than that of the conventional group(45+10)mm.The CCU transfer time,bedtime activity time,gastrointestinal function recovery time,and hospitalization time of the experimental group were(50.2±10.2)hours,(1.2±0.3)days,(24.1±5.2)hours,and(8.5±1.5)days,respectively,which were lower than those of the conventional group[(55.3±10.8)hours,(2.2±0.8)days,(27.3±5.2)hours,and(10.2±2.3)days].The incidence of complications in the experimental group was 8%(4/49)lower than that in the conventional group 20%(10/49)(P<0.05).Conclusion Perioperative risk management based on evidence-based medicine can improve the negative emotions of CCU arrhythmia patients,enhance surgical efficacy,accelerate the postoperative recovery process,and reduce surgical risks.
作者
张蕊
王新颖
李申
Zhangrui;Wang Xinying;Lishen(Cardiovascular Intensive Care Unit',the First People's Hospital of Nanyang City,Henan 473003,China)
出处
《山西医药杂志》
CAS
2024年第7期483-487,共5页
Shanxi Medical Journal
基金
河南省医学科技攻关项目(LHGJ202100221)。
关键词
心律失常
心性
循证医学
风险调节
射频消融术
康复研究
Arrhythmias,cardiac
Evidence-based medicinei Risk adjustmenti Radiofrequency ablationi Rehabilitationresearch
