急性心肌梗死介入治疗术后再发的危险因素分析与预防护理对策  

Risk factors analysis of recurrence after intervention therapy in acute myocardial infarction and its preventive nursing measures

作　　者：王颖[1] WANG Ying

机构地区：[1]山东大学齐鲁医院护理部,济南市250000

出　　处：《护理实践与研究》2018年第12期8-10,共3页Nursing Practice and Research

摘　　要：目的急性心肌梗死(AMI)介入治疗后再发的危险因素及护理预防分析。方法以我院149例诊断为AMI患者并予以经皮冠脉介入术治疗(PCI)治疗的临床资料为研究对象,所有患者术后随访4年,根据是否复发分为初发组与再发组,比较两组临床资料,分析AMI者PCI术再发入院的危险因素,并针对高危因素制定相应护理措施。结果 149例患者中26例出现再发心肌梗死,单因素分析中,初发组平均年龄、高血压、糖尿病、高脂血症、吸烟史、Killp Ⅱ～Ⅳ级、术前LVEF、多支病变等构成比及服药依从性评分均显著低于再发组(P<0.05);性别、饮酒史、栓塞血管分类、术后TIMI血流等资料差异均无统计学意义(P>0.05);对上述影响因素进行Logistic回归分析,显示年龄、糖尿病、吸烟史、Killp Ⅱ～Ⅳ级、多支病变等资料是影响AMI患者PCI术后再发心肌梗死的独立危险因素,术前LVEF、服药依从性是保护因素(P<0.05);术后还需加强药物治疗及健康宣教。结论 AMI患者PCI术后再发心肌梗死的危险因素与年龄、合并证、心功能、服药依从性有关,术后应结合上述影响因素进行相应干预,避免再发心肌梗死。Objective To analyze the risk factors and nursing prevention of recurrence after the intervention therapy of acute myocardial infarction（AMI） in patients. Methods The clinical data of 149 patients who were diagnosed as AMI and underwent percutaneous coronary intervention（PCI） treatment in our hospital were selected as the study subjects. All patients were followed up for 4 years. The patients were divided into primary group and recurrent group according to whether they had disease relapse. The clinical data were compared between the two groups. Further more,the risk factors of hospital admissions for AMI patients who had recurrence after the PCI surgery were analyzed and the corresponding nursing measures for high-risk factors were made. Results Recurrent myocardial infarction occurred in 26 of 149 patients. The univariate analysis results showed that the scores of average age,hypertension,diabetes,hyperlipidemia,smoking history,Killp Ⅱ-Ⅳ level,preoperative LVEF,multi-vessel lesion proportion and medication compliance in the primary group were all significantly lower than those of the recurrent group（P 〈 0. 05）. There was no statistically significant difference in gender,drinking history,embolization of vessels category,and postoperative TIMI blood flow（P 〉 0. 05）. Logistic regression analysis was performed on these influencing factors. The results showed that data such as age,diabetes,smoking history,Killp Ⅱ-Ⅳ level,and multi-vessel disease are independent risk factors for recurrent myocardial infarction after PCI in AMI patients. Preoperative LVEF and medication compliance are protective factors（P 〈 0. 05）. Drug treatment and health education should be strengthened after the operation. Conclusion The risk factors for recurrent myocardial infarction after PCI in AMI patients are related to age,complications,heart function and medication compliance. After the operation,it should combine the above factors to conduct intervention,thus avoiding recurrence of acute myocardial infarct

关 键 词：急性心肌梗死 PCI术 危险因素 护理预防 

分 类 号：R473.5[医药卫生—护理学]