劉琦　張奇軍

[摘要] 目的 探討綜合性護理干預對冠心病介入治療患者心理狀態(tài)及生活質(zhì)量的影響。方法 選取2009 年 1月～2014 年 1月期間在我院行冠心病介入治療的患者60例，將上述患者隨機分成干預組與對照組各30例，對照組患者給予隨機對癥護理，干預組于介入手術(shù)圍術(shù)期著重實施綜合性護理干預措施，比較兩組的SAS評分及QOL評分。結(jié)果 術(shù)后3 d，干預組和對照組患者的SAS評分均較術(shù)前1 d及術(shù)后1 d明顯降低，且干預組術(shù)后3 d的SAS評分明顯低于對照組 （P<0.05）；出院后3個月，干預組和對照組患者的生理、心理、獨立性、社會關(guān)系、環(huán)境和生活質(zhì)量總分均較干預前顯著提高，且干預組明顯高于對照組（P<0.05）。結(jié)論 圍術(shù)期實施綜合性護理干預是冠心病患者介入治療過程的重要組成部分，可以緩解患的緊張、焦慮的心理狀態(tài)，提高手術(shù)成功率，進一步提高患者的生活質(zhì)量。

[關(guān)鍵詞] 冠心病；介入治療；綜合性；護理干預；生活質(zhì)量

[中圖分類號] R473.5 [文獻標識碼] B [文章編號] 1673-9701（2014）23-0068-04

[Abstract] Objective To investigate the effect and impact on mental state and quality of coronary intervention life of patients of comprehensive nursing intervention. Methods From January 2009 to January 2014 in our hospital， 60 patients with coronary heart disease by coronary intervention were randomly divided into intervention group and the control group， each of 30 patients， the control group were randomly given symptomatic treatment， observation group focused on the implementation of integrated perioperative nursing interventions， the SAS score and QOL score were compared. Results After three days， the intervention group and the control group of SAS scores were lower than that in one day before and after surgery， and the SAS score of intervention group after three days was significantly lower than the control group （P<0.05）； After 3 months of discharge， physiological， psychological， independence， social relationships， environment and quality of life scores in intervention group and the control group were significantly improved than before the intervention， and the intervention group were significantly higher than the control group（P <0.05）. Conclusion Implementation of comprehensive perioperative nursing intervention is an important part of the process of intervention in patients with coronary artery disease， patients can ease tension， anxiety mental state， improve the success rate of surgery and can further improve the quality of life of patients.

[Key words] Coronary heart disease； Interventional therapy； Comprehensive； Nursing interventions； Quality of life

經(jīng)皮冠狀動脈介入（percutaneous coronary intervention，PCI）治療冠心病具有創(chuàng)傷小、見效快、療效顯著等優(yōu)點，現(xiàn)已經(jīng)廣泛應用于臨床[1]。但由于冠脈介入術(shù)風險高、費用貴、手術(shù)后并發(fā)癥的存在，冠心病患者在手術(shù)前后普遍存在著焦慮心理，嚴重影響其臨床療效和遠期預后、生活質(zhì)量。因此，冠心病介入治療的臨床效果不僅與醫(yī)師的操作技術(shù)經(jīng)驗密切相關(guān)，還與圍手術(shù)期綜合性護理干預措施的實施密不可分[2]。本研究旨在探討綜合性護理干預對冠心病介入治療患者心理狀態(tài)及生活質(zhì)量的影響，現(xiàn)報道如下。

1 資料與方法

1.1臨床資料

選取2009 年 1月～2014 年 1月期間在我院行冠心病介入治療的患者60例，排除對β受體阻滯劑、血管緊張素轉(zhuǎn)換酶抑制劑、調(diào)脂藥物、抗血小板聚集藥物過敏者，排除患有惡性腫瘤、嚴重肝腎功能不全等疾病及精神異常者。隨機將上述患者分成干預組與對照組各30例，其中干預組30例，男19 例，女11例，年齡 48～72 歲，平均（55.2±7.8）歲；單支冠脈病變14例，雙支病變12例，三支病變4例。合并高血壓11例，糖尿病8例。對照組 30 例，男20例，女10 例，年齡 46～73 歲，平均（54.3±6.5）歲。其中單支冠脈病變16例，雙支病變9例，三支病變5例。合并高血壓12例，糖尿病5例。兩組患者性別、平均年齡、冠脈病變及合并高血壓、糖尿病等一般資料比較，差異無統(tǒng)計學意義（P>0.05），具有可比性。見表1。endprint