冠心病患者心脏体外震波治疗护理流程及其安全性分析  

Analysis on nursing procedure and safety of cardiac show wave therapy in coronary artery disease patients

作　　者：田春梅 郑京京 贾娜[1] 何青[1] 刘保逸[1] 刘君萌[1] 张瑞生[1] 齐欣[1] 蓝明[1] 刘兵[1] Tian Chunmei;Zheng Jingjing;Jia Na;He Qing;Liu Baoyi;Liu Junmeng;Zhang Ruisheng;Qi Xin;Lan Ming;Liu Bing(Cardiology Department,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Science,Beijing 100730,China)

机构地区：[1]北京医院心血管内科,国家老年医学中心,中国医学科学院老年医学研究院,北京100730

出　　处：《中国医学前沿杂志（电子版）》2023年第3期53-58,共6页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：北京医院院内课题(BJ-2019-159);中央高水平医院临床科研业务费(121-2016004)。

摘　　要：目的探索冠心病患者心脏体外震波治疗(cardiac shock wave therapy,CSWT)护理流程及安全性。方法选取2016年12月至2022年8月在北京医院就诊的冠心病并行CSWT的患者。收集临床基本资料,总结护理流程的关键点。收集加拿大心绞痛(Canadian Cardiology Society,CCS)分级、西雅图量表(Seattle Angina Questionnaire,SAQ)、6分钟步行试验(6-minute walk test,6MWT)、治疗中的心电图参数和血清心肌标志物的结果。比较治疗前后生命体征、心电图参数、血清心肌标志物、SAQ和6MWT距离的变化。结果共有105例患者最终纳入了此研究,男性79例,女性26例,平均年龄为(69.39±9.35)岁。人文关怀贯穿于治疗前后和治疗中。CSWT前后,心率、收缩压、舒张压、血氧饱和度数值变化差异有统计学意义(P<0.001),但均在正常范围内波动。肌酸激酶同工酶(creatine kinase MB type,CK-MB)在治疗前后没有变化(P=0.840),血清心肌标志物包括肌钙蛋白(troponin T,TNT)(P=0.007)和脑钠肽(brain na-triuretic peptide,BNP)(P=0.033),变化差异具有统计学意义,但其中位数均在正常范围内。治疗前后的QRS间期(P=0.236)无明显改变,心率(P<0.001)、PR间期(P<0.001)和QT间期(P<0.001)均具有显著变化,但均在正常范围。CCS分级在治疗后明显改善(2.62级vs.1.92级,P<0.001)、SAQ的5个条目均在治疗后显著改善(P<0.001)、6MWT距离在治疗后明显提高(P<0.001)。结论CSWT的护理过程中需要人文关怀。冠心病患者接受CSWT安全,CSWT可以改善患者心绞痛症状、提高活动能力及改善生活质量。Objective To explore the nursing procedure and safety of cardiac shock wave therapy(CSWT)in coronary artery disease(CAD)patients.Methods CAD patients who received CSWT in Cardiology Department of Beijing Hospital from December 2016 to August 2022 were enrolled.Nursing key procedure were described.Clinical data,Canadian Cardiology Society(CCS)classification,Seattle Angina questionnaire(SAQ),6-minute walk test(6MWT),electrocardiographic data and serum cardiac markers were collected.Vital sign,electrocardiographic data,serum cardiac markers,SAQ and 6MWT distance were compared.Results A total of 105 patients were finally enrolled.There were 79 male and 26 female patients with an average age of(69.39±9.35)years old.Humanistic care was throughout the nursing procedure.The change of heart rate,systolic blood pressure(BP),diastolic BP,saturation of oxygen showed significant difference with P<0.001.The change of the parameters all fluctuated within normal range.CK-MB did not change significantly(P=0.840).TNT(P=0.007)and BNP(P=0.033)showed significantly difference after CSWT.But the median value were all in normal range.QRS internal(P=0.236)did not change significantly(P<0.001),while PR interval(P<0.001)and QT interval(P<0.001)changed significantly with the normal range fluctuation.CCS classification deceased significantly(2.62 levels vs.1.92 levels,P<0.001).The five domains of SAQ were all showed significantly improved and the distance of 6MWT significantly increased(P<0.001)after CSWT.Conclusions CSWT nursing procedure needs humanistic care.CSWT may be a safety treatment in CAD patients,which can improve ischemic symptom,increase exercise capacity and quality of life.

关 键 词：冠心病 心脏体外震波治疗 护理 安全性 

分 类 号：R473.5[医药卫生—护理学]