冠心病介入治疗患者静息心率控制现状及影响因素调查  

Investigation on the control status of resting heart rate after percutaneous coronary intervention and its influencing factors

作　　者：彭倩 杨展[1] 张宝凤[1] 张利娟[1] 唐姗钐 张辉[1] 沈瑶 Peng Qian;Yang Zhan;Zhang Baofeng;Zhang Lijuan;Tang Shanshan;Zhang Hui;Shen Yao(Heart Rehabilitation Centre,Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China)

机构地区：[1]郑州大学第二附属医院心脏康复中心,河南郑州450014 [2]郑州大学医学科学院

出　　处：《护理学杂志》2020年第24期33-36,共4页Journal of Nursing Science

基　　金：河南省医学科技攻关计划项目(201702086)。

摘　　要：目的了解冠心病介入治疗患者术后1年静息心率控制情况并分析其影响因素,为提高患者治疗依从性措施制定和实施提供参考。方法对232例行冠脉介入手术的患者进行为期1年的随访,记录随访对象出院前,术后1、3、6、12个月静息心率,术后1年再住院及心脑血管事件再发的情况。结果共222例患者完成随访。5个时间段静息心率达标的患者占比依次是28.45%、32.33%、34.06%、35.84%、33.33%。其中,静息心率出院前最高(68.87±8.13)次/min,术后6个月最低(63.67±5.48)次/min。术后1年再住院率、心脑血管事件再发率分别为27.48%、24.32%。回归分析结果显示,糖尿病、吸烟进入5个时间段,遵医嘱服用β受体阻滞剂及收缩压进入4个时间段,年龄、心率控制认知2个变量进入出院前、术后12个月时间段影响因素预测模型(P<0.05,P<0.01)。结论冠心病介入术后患者静息心率控制达标率有待提升,医护人员应加强患者戒烟教育、血糖管理及血压控制,提高患者静息心率控制认知及服药依从性。Objective To understand to what extent patients control resting heart rate one year after percutaneous coronary intervention(PCI),and explore the factors influencing control of resting heart rate.Methods A total of 232 patients after coronary intervention were followed up by telephone for 1 year,and resting heart rates were recorded before discharge,and 1,3,6,12 months post-PCI.Readmission and recurrence of cardiovascular and cerebrovascular events within one year after the operation were also documented.Results A total of 222 patients completed the study.The percentage of patients whose resting heart rate was controlled within standard range were 28.45%,32.33%,34.06%,35.84%,and 33.33%at the 5 time points.The highest resting heart rate was(68.87±8.13)beats/min before discharge,and the lowest was(63.67±5.48)beats/min 6 months post-PCI.The readmission rate was 27.48%,and the recurrence rate of cardiovascular and cerebrovascular events was 24.32%one year after the operation.The control of resting heart rate at 5 time points was respectively treated as the dependent variable,and the results of logistic regression analysis showed that,smoking and diabetes influenced control of resting heart rate at 5 time points;βreceptor blockers and systolic blood pressure weighed on control of resting heart rate at 4 time points;age,and heart rate control knowledge level weighed at 2 time points(before discharge,and 12 months post-PCI).Conclusion Overall resting heart rate control after PCI in patients with coronary heart disease needs to be improved.Medical staff are recommended to help patients quit smoking,lower blood pressure and control blood glucose levels.In addition,it is of significance to improve patients′resting heart rate control knowledge level and medication compliance.

关 键 词：冠心病 经皮冠状动脉介入治疗 PCI 静息心率 心血管系统 不良事件 影响因素 

分 类 号：R473.5[医药卫生—护理学]