摘要
目的:探究多元改良流程化管理干预对重症冠心病(CHD)患者心功能、心理状态、应激水平、睡眠质量和不良事件的影响。方法:本随机对照研究纳入2020年1月-2023年5月于首都医科大学附属北京世纪坛医院接受治疗的130例重症CHD患者,分为对照组(n=65)与干预组(n=65),对照组采用常规管理干预,干预组在对照组基础上给予多元改良流程化护理干预,两组均干预4周。对比两组患者心功能、去甲肾上腺素(NE)和皮质醇(COR)水平、焦虑自评量表(SAS)、抑郁自评量表(SDS)、舒适状况量表(GCQ)、匹兹堡睡眠指数(PSQI)评分,以及干预期间不良事件发生率。结果:干预后,与对照组相比,干预组左心室射血分数(LVEF)[(57.81±2.15)%比(50.11±2.99)%]、GCQ评分[(95.88±5.37)分比(75.81±6.67)分]显著增加(P均<0.001);左心室舒张末期容积(LVEDV)[(109.81±5.37)ml比(129.26±5.17)ml]、左心室收缩末期容积(LVESV)[(50.85±3.08)ml比(66.02±3.77)ml]、NE[(61.56±5.49)pg/ml比(69.86±5.03)pg/ml]、COR[(85.63±5.19)ng/ml比(92.28±6.57)ng/ml]、SAS[(30.06±5.19)分比(49.51±5.85)分]、SDS[(31.86±4.51)分比(40.00±5.10)分]、PSQI评分[(8.72±1.58)分比(13.89±2.40)分]和不良事件发生率(4.69%比23.44%)显著降低(P均<0.01)。结论:多元改良流程化管理干预可有效改善重症CHD患者心功能、不良心理状态、应激水平、睡眠质量,降低不良事件发生率。
Objective:To explore the effect of multiple modified process management intervention on cardiac function,psychological state,stress level,sleep quality and adverse events in patients with severe coronary atherosclerotic heart disease(CHD).Methods:This randomized controlled study enrolled 130 severe CHD patients who were treated in Affiliated Beijing Shijitan Hospital of Capital Medical University between January 2020 and May 2023.Patients were randomly divided into control group(n=65)and intervention group(n=65).Patients in the control group were treated with routine management intervention,while those in the intervention group were given additional multiple modified process management interventions.Both groups were intervened for 4 weeks.Cardiac function,levels of norepinephrine(NE)and cortisol(COR),scores of Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS),General Comfort Questionnaire(GCQ),Pittsburgh Sleep Quality Index(PSQI),and the incidence of adverse events during intervention were compared between the two groups.Results:Compared to those in control group after intervention,patients in intervention group had significant higher left ventricular ejection fraction(LVEF)[(57.81±2.15)%vs.(50.11±2.99)%]and GCQ score[(95.88±5.37)points vs.(75.81±6.67)points](P<0.001 all),and significant lower left ventricular end-diastolic volume(LVEDV)[(109.81±5.37)ml vs.(129.26±5.17)ml],left ventricular end-systolic volume(LVESV)[(50.85±3.08)ml vs.(66.02±3.77)ml],levels of NE[(61.56±5.49)pg/ml vs.(69.86±5.03)pg/ml],COR[(85.63±5.19)ng/ml vs.(92.28±6.57)ng/ml],scores of SAS[(30.06±5.19)points vs.(49.51±5.85)points],SDS[(31.86±4.51)points vs.(40.00±5.10)points]and PSQI[(8.72±1.58)points vs.(13.89±2.40)points],and incidence of adverse events(4.69%vs.23.44%)(P<0.01 all).Conclusion:The multiple modified process management intervention may improve the cardiac function,adverse psychological state,stress level,sleep quality and reduce the incidence of adverse events in patients with severe CHD.
作者
谭晶晶
陈炜
甄洁
刘东岩
高梦琦
闯冬梅
TAN Jing-jing;CHEN Wei;ZHEN Jie;LIU Dong-yan;GAO Meng-qi;CHUANG Dong-mei(Supply Room,Affiliated Beijing Shijitan Hospital of Capital Medical University,Beijing,100038,China)
出处
《心血管康复医学杂志》
2025年第4期475-480,共6页
Chinese Journal of Cardiovascular Rehabilitation Medicine
基金
2022年度北京市重大疫情防治重点专科项目(ZDYQFZZDZK)。
关键词
冠心病
心理疗法
护理
Coronary disease
Psychotherapy
Nursing care
