经导管主动脉瓣置换术后患者睡眠质量的影响因素分析  

作　　者：任晓碧[1] 杨微 杨伟力 薛杨静 

机构地区：[1]温州医科大学附属第二医院(育英儿童医院),325027

出　　处：《浙江临床医学》2024年第2期278-279,282,共3页Zhejiang Clinical Medical Journal

摘　　要：目的评估经导管主动脉瓣置换术(TAVR)患者的睡眠质量变化并分析其影响因素。方法应用阿森斯失眠量表(AIS)和视觉模拟量表(VAS)分别进行TAVR术前和术后患者的睡眠质量和疼痛程度评分并进行比较。根据前期开放式访谈结果自行设计相应调查问卷,进一步Logistic回归统计分析TAVR患者术后睡眠质量的主要影响因素,并探讨有效的护理干预措施。结果TAVR术后患者AIS评分和VAS评分均较术前显著升高(均P<0.001)。92.59%的患者认为术后疼痛和下肢固定对其睡眠有显著影响。85.19%和79.63%的患者分别认为受病房环境或同病房患者影响,以及CICU设备运行的噪音和亮度等明显干扰睡眠。二元Logistic回归分析结果示术后疼痛和下肢固定及CICU设备运行的噪音和亮度是影响TAVR患者术后睡眠质量最重要的因素。佩戴音乐耳机可改善睡眠质量。结论TAVR患者术后疼痛明显加剧、睡眠质量明显下降。术后疼痛和CICU设备运行的声光是影响其术后睡眠质量最重要的影响因素。及时的疼痛评估和管理、有效的噪音控制及音乐耳机有助于患者的睡眠质量改善和预后恢复。Objective To evaluate the sleep quality of patients after transcatheter aortic valve replacement(TAVR),and analyze its influencing factors.Methods The Athens Insomnia Scale(AIS)and Visual Analogue Scales(VAS)were used to evaluate sleep quality and pain tensions of those who underwent TAVR,respectively.Based on the results of the preliminary open-ended interviews,a corresponding survey questionnaire was designed.Logistic regression statistical analysis was then conducted to identify the primary factors influencing the post-TAVR patients'sleep quality,and effective nursing intervention measures were explored.Results Both AIS and VAS scores significantly increased after TAVR(all P<0.001).92.59% of patients believed that postoperative pain and lower limb immobilization had a significant impact on their sleep.85.19% and 79.63% of patients respectively believed that the ward environment and the operation noise and brightness of cardiac intensive care unit(CICU)equipment significantly interfered with their sleep.In the multivariate binary regression model,postoperative pain and lower limb immobilization and the operation noise and brightness of CICU equipment were identified as the independent factors of poor sleep quality after TAVR.Music headphones could help improve patients'sleep and prognosis recovery.Conclusion TAVR patients have significantly worse postoperative pain and significantly worse sleep quality.Postoperative pain and the sound and light of CICU equipment operation are the most important influencing factors on postoperative sleep quality.Timely pain assessment and management,as well as effective noise control and music headphones,can help patients improve their sleep quality and prognosis recovery.

关 键 词：经导管主动脉瓣置换术 睡眠质量 术后疼痛 护理 

分 类 号：R473.6[医药卫生—护理学]