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目的:探讨急性冠脉综合征(ACS)患者行急诊直接经皮冠状动脉介入治疗(PCI)后住院期间发生心力衰竭(HF)的危险因素分析及护理干预策略。方法:选取278例在我院接受急诊PCI手术患者为研究对象,按照术后住院期间是否出现心力衰竭分为两组:心力衰竭组(n=54例)和非心力衰竭组(n=224例),比较两组患者一般临床资料、实验室检查指标及相关治疗情况的差异,用Logistic回归分析探讨影响术后心力衰竭发生的危险因素,并制定相关护理策略。结果:278例老年患者中有54例PCI术后出现心力衰竭(发生率19.4%);两组患者在年龄、高血压、糖尿病、入院收缩压(SBP)、发病至PCI时间、入院血糖、入院NT-pro BNP、肌酸激酶同工酶(CK-MB)峰值、肌酐蛋白I(c Tn I)峰值、左室射血分数(LVEF)、左室舒张末内径(LVEDd)、术后TIMI血流、使用他汀类药物、β-受体阻滞剂方面存在统计学差异(P<0.05);发病至PCI时间、高血压、入院时血糖、NT-pro BNP、c Tn I峰值是术后心力衰竭发生的独立危险因素(P<0.05);而术后TIMI血流、使用β-受体阻滞剂治疗是保护性因素。结论:ACS患者行急诊PCI治疗后HF的发生受到多种因素的影响,应当积极制定相关护理干预策略以降低术后HF的发生率。
Objective: To investigate the risk factors and nursing intervention strategies of heart failure (HF) during hospitalization after acute percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS). Methods: A total of 278 patients undergoing emergency PCI in our hospital were enrolled in this study. Patients were divided into two groups: heart failure group (n = 54) and non-heart failure group (n = 224) ). The differences of general clinical data, laboratory indexes and related treatment between the two groups were compared. Logistic regression analysis was used to explore the risk factors influencing postoperative heart failure and to develop related nursing strategies. Results: 54 of 278 elderly patients had heart failure after PCI (the incidence rate was 19.4%). There were no significant differences in age, hypertension, diabetes mellitus, admission systolic pressure (SBP), incidence to PCI time, NT-pro BNP, CK-MB, cTn I peak, left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDd), postoperative TIMI blood (P <0.05); incidence to PCI time, hypertension, blood glucose at admission, peak NT-pro BNP and cTn I were postoperative heart rate Failure independent risk factors (P <0.05); postoperative TIMI blood flow, the use of β-blocker therapy is a protective factor. Conclusions: The incidence of HF after ACS is influenced by many factors and the relevant nursing intervention strategies should be actively developed to reduce the incidence of postoperative HF.