血浆脑钠肽水平监测联合连续性护理干预对行急诊PCI的急性心肌梗死患者预后的影响  

Effect of monitoring the plasma brain natriuretic peptide levels combined with continuous nursing intervention on the prognosis of patients with acute myocardial infarction who undergone emergency percutaneous coronary intervention

作　　者：胡铭[1] 刘孝钧[2] 刘玉玲[1] 张鸿举[2] 李伟[2] 

机构地区：[1]徐州市第一人民医院护理部,221002 [2]徐州市第一人民医院心内科,221002

出　　处：《中华现代护理杂志》2014年第8期891-893,共3页Chinese Journal of Modern Nursing

基　　金：徐州市社会发展科技计划项目（XZZD1113）

摘　　要：目的了解急性心肌梗死（AMI）行急诊PCI的患者血浆脑钠肽（BNP）的水平，探讨护理方法及效果。方法选择130例因AMI行急诊PCI的患者，按照入院顺序分成干预组和对照组，每组各65例，对照组给予常规治疗及护理，干预组在此基础上根据测定BNP的水平进行危险分级，给予针对性护理干预，调查两组患者6个月内再发生不良心血管事件的情况，应用西雅图心绞痛生存质量测量量表（SAQ）对两组患者生活质量情况进行评估。结果干预组再发生不良心血管事件（心力衰竭、心肌梗死、心律失常、心绞痛、心源性死亡）4例（6．2％），明显低于对照组15例（23．1％），两组比较差异有统计学意义（X^2=7．45；P〈0．01）。干预组SAQ量表活动受限、心绞痛发作、心绞痛稳定、治疗满意度、主观感受各因子得分及量表总分分别为（79．69±11．87），（95．13±13．02），（91．32±11．05），（79．86±8．39），（74．12±14．18），（82．50±15．12）分，均高于对照组的（60．28±9．73），（84．60±10．89），（78．24±9．59），（68．21±7．45），（60．56±11．64），（69．45±13．26）分，两组比较差异有统计学意义（t值分别为8．02，5．23，5．95，7．14，7．88，6．45；P〈0．01）。结论根据急诊PCI患者血浆BNP的检测水平，实施护理干预可减少不良心血管事件的再发生率，提高其生活质量。Objective To investigate the plasma brain natriuretic peptide （BNP） levels in the acute myocardial infarction （AMI） patients who undergone emergency percutaneous coronary intervention （PCI）, and to explore the method and effect of nursing. Methods One hundred and thirty AMI patients with emergency PCI were divided into the intervention group and the control group according to the order of admission, each with 65 cases. The control group received the routine treatment and nursing, and the intervention group received the specific nursing intervention according to the level of BNP on the basis of the control. The major adverse cardiovascular events （MACE） were investigated within the six months of follow-up, and the quality of life was evaluated by the Seattle angina questionnaire （SAQ） in the two groups. Results The cases of MACE including heart failure, myocardial infarction, arrhythmia, angina pectoris, sudden cardiac death were four cases （6. 2% ） in the intervention group, and were significantly lower than fifteen cases （23.1% ） in the control group, and the difference was statistically significant （ X^2 = 7.45 ; P 〈 0. 01 ）. The scores of SAQ including the activity limitation, the attack of angina pectoris, the stability of angina pectoris, treatment satisfaction, subjective feeling and total were respectively （79. 69 ± 11.87）, （95.13 ± 13.02）, （91.32 ± 11.05）, （79. 86 ± 8. 39）, （74. 12 ± 14. 18）, （82. 50 ± 15. 12） in the intervention group, and were higher than （60. 28 ± 9. 73 ）, （ 84. 60 ± 10. 89）, （78. 24 ±9. 59）, （68.21 ±7.45）, （60. 56 ± 11.64）, （69.45 ± 13.26） in the control group, and the differences were statistically significant （ t = 8.02,5.23,5.95,7. 14,7. 88,6. 45, respectively; P 〈 O. O1 ）.Conclusions According to the level of BNP in the patients with emergency PCI, the specific nursing intervention can reduce the incidence rate of MACE and improve the life quality of the patients.

关 键 词：急性心肌梗死 急诊 经皮冠状动脉介入术 脑钠肽 护理干预 

分 类 号：R473.5[医药卫生—护理学]