2型糖尿病合并左冠状动脉主干狭窄患者介入治疗的循证护理  

Evidence- based Nursing for T2DM Patients with Left Main Coronary Artery Who Received Interventional Therapy

作　　者：左雪飞[1] 

机构地区：[1]南华大学附属第一医院心血管内科,湖南省衡阳市421001

出　　处：《中国全科医学》2015年第8期941-945,共5页Chinese General Practice

摘　　要：目的探讨左冠状动脉主干(LMCA)狭窄的2型糖尿病(T2DM)患者接受介入治疗的循证护理措施及其对预后结局的改善效果。方法选取2012年6月—2013年5月在南华大学附属第一医院心血管内科住院的T2DM合并LMCA狭窄患者28例为研究组,实施介入治疗及循证护理。收集2011年6月—2012年5月在该科住院的T2DM合并LMCA狭窄患者28例为对照组,仅施以介入治疗及常规护理。比较两组介入治疗后穿刺点出血量、冠心病监护病房(CCU)入住时间、室性期前收缩(VPC)发生率及收缩压(SBP)、舒张压(DBP)、左室射血分数(LVEF)、心脏指数(CI)、随机血糖(RBG)水平的差异;比较两组随访6个月时主要不良心血管事件(MACE)发生率、血糖达标率、生活质量综合评分(QOL)及并发症发生率的差异。结果研究组的穿刺点出血量、CCU入住时间、VPC发生率及RBG水平均较对照组降低,而SBP、DBP、LVEF及CI较对照组增加,差异有统计学意义(P<0.05)。随访6个月时,研究组患者MACE发生率、并发症发生率较对照组降低,血糖达标率、QOL升高,差异有统计学意义(P<0.05)。结论应用循证护理措施对于接受介入手术的LMCA合并T2DM患者疗效显著,并可改善预后结局。Objective To evaluate the evidence- based nursing for T2 DM patients with left main coronary artery（ LMCA） who received interventional therapy and its prognosis improvement. Methods From June 2012 to May 2013,in the First Affiliated Hospital, University of South China,28 hospitalized T2 DM patients with LMCA（ study group） were given interventional therapy and evidence- based nursing; another 28 T2 DM with LMCA hospitalized from June 2011 to May 2012（ control group） given interventional therapy and conventional nursing. The bleeding volume,CCU stay,incidence of ventricular premature contraction（ VPC）,SBP,DBP,left ventricular ejection fraction（ LVEF）,cardiac index（ CI）,random blood glucose（ RBG） were compared between 2 groups after interventional therapy; the incidence of major adverse cardiovascular events（ MACE） and complications,control rate of blood glucose（ BG）,comprehensive scores of quality of life（ QOL） were compared between 2 groups after months 6 of follow- up. Results The bleeding volume,CCU stay,VPC incidence and RBG level were lower,SBP,DBP,LVEF,CI higher in study group than in control group, the difference was significant（ P 0. 05）. In months 6 of follow- up,incidences of MACE complications were lower,control rate of BG,QOL scores higher in study group than in control group（ P 0. 05）. Conclusion The effectiveness of evidence- based nursing is remarkable for T2 DM patients with LMCA who receive interventional therapy and improve their prognosis.

关 键 词：护理评估 糖尿病 2型 冠状动脉狭窄 冠状动脉旁路移植术 非体外循环 循证护理学 

分 类 号：R473[医药卫生—护理学] R587.1[医药卫生—临床医学]