综合干预对急性心肌梗死行主动脉内球囊反搏治疗患者焦虑状况的效果分析  

Effect of Comprehensive Intervention on Anxiety in Patients with Acute Myocardial Infarction undergoing Intra-aortic Balloon Pump

作　　者：邱小芩[1] 肖熙[1] 岑莉莉 李彩艳[1] 陶艳娇 

机构地区：[1]广西壮族自治区人民医院心血管内科,广西南宁市530021

出　　处：《中国康复理论与实践》2014年第8期771-775,共5页Chinese Journal of Rehabilitation Theory and Practice

基　　金：广西壮族自治区卫生厅科研项目(No.Z2012297)

摘　　要：目的：探讨综合干预对急性心肌梗死（AMI）行主动脉内球囊反搏（IABP）患者焦虑情绪的影响。方法选择经汉密尔顿焦虑量表（HAMA）评价大于14分的50例AMI行IABP治疗患者，分为常规干预组（n=25）和综合干预组（n=25）。常规干预组给予含认知行为干预在内的所有常规护理措施，综合干预组在此基础上加用丙泊酚静脉泵入，Ramsay镇静分级在Ⅱ～Ⅲ级。记录两组患者干预前、干预后第1～5天6个时间点的生命体征、HAMA得分、主要心血管事件和血管并发症的发生情况。结果综合干预组干预后多数时间点HAMA得分、收缩压、舒张压、平均压较干预前降低（P〈0.05），未增加低血压、呼吸抑制等并发症。综合干预组恶性心律失常、穿刺部位出血/血肿、导管移位等发生率低于常规干预组（P〈0.05）。结论综合干预能够改善AMI行IABP患者的焦虑症状，降低心律失常、血管并发症和IABP导管移位发生率。Objective To explore the effect of comprehensive intervention on anxiety in patients of acute myocardial infarction （AMI） undergoing intra-aortic balloon pump （IABP）. Methods 50 patients with AMI undergoing IABP with the score of Hamilton Anxiety Rating Scale （HAMA） more than 14 points, were divided into conventional intervention group （n=25） and comprehensive intervention group （n=25）. The conventional intervention group received all the conventional nursing measures including cognitive behavioral intervention, and the comprehensive intervention group received propofol intravenous pumping in addition with Ramsay sedation at II-III level. The vital signs, HAMA scores, major cardiovascular events, and vascular complications were recorded before and the 1st-5th days after intervention. Re-sults The HAMA scores, systolic blood pressure, diastolic blood pressure and mean pressure decreased in most of the time points after inter-vention in the comprehensive intervention group （P〈0.05）. And there was no complication such as low blood pressure, respiratory depres-sion. The incidence rates of cardiac arrhythmias, puncture hematoma/bleeding and catheter displacement were lower in the comprehensive intervention group than in the conventional intervention group （P〈0.05）. Conclusion Comprehensive intervention can improve the symp-toms of anxiety in the patients with AMI undergoing IABP, and reduce the incidence of arrhythmia, vascular complications and catheter dis-placement.

关 键 词：急性心肌梗死 主动脉内球囊反搏 焦虑 

分 类 号：R541.4[医药卫生—心血管疾病]