结局回溯性教育联合强化家庭随访的个案管理模式在PCI术后的应用  

Application of outcome retrospective education combined with case management model of intensive family follow-up after PCI

作　　者：韩梅 宋宪辉 孟园 HAN Mei;SONG Xianhui;MENG Yuan(The Second Affiliated Hospital of Shandong First Medical University,Taian,Shandong,271000,China)

机构地区：[1]山东第一医科大学第二附属医院,山东泰安271000

出　　处：《中西医结合护理（中英文）》2023年第12期13-16,共4页Journal of Clinical Nursing in Practice

摘　　要：目的 考察结局回溯性教育联合强化家庭随访的个案管理模式在急性心肌梗死患者行经皮冠状动脉介入术(PCI)后的应用效果。方法 选取2021年1月至2022年12月在山东第一医科大学第二附属医院行PCI治疗的80例急性心肌梗死患者为研究对象,根据干预方式的差异将其分为观察组和对照组,每组40例。对照组给予常规护理,观察组给予结局回溯性教育联合强化家庭随访的个案管理。比较2组的心功能、运动耐力、遵医行为、生活质量、心理弹性及主要心血管不良事件(MACEs)发生情况。结果 干预1个月和3个月后,观察组的左室舒张末期内径(LVEDD)均小于同期对照组,左室射血分数(LVEF)和6分钟步行距离(6MWT)均大于同期对照组,西雅图心绞痛量表(SAQ)和心理弹性量表(CD-RISC)评分均高于同期对照组(P均<0.05),且2组的上述指标均较干预前改善(P均<0.05);干预3个月后,2组的上述指标均较干预1个月后有所改善(P均<0.05)。观察组规范用药、合理膳食、适当运动、戒烟戒酒和定期复查的遵医率均高于对照组,MACEs总发生率低于对照组(P均<0.05)。结论 结局回溯性教育联合强化家庭随访的个案管理模式可改善急性心肌梗死患者行PCI术后的心功能、运动耐力和遵医行为,提高患者的生活质量和心理弹性,减少MACEs的发生。Objective To investigate the application effect of outcome retrospective education combined with case management model of intensive family follow-up in patients with acute myocardial infarction after percutaneous coronary intervention(PCI).Methods Eighty patients with acute myocardial infarction who underwent PCI at the Second Affiliated Hospital of Shandong First Medical University from January 2021 to December 2022 were enrolled.They were assigned into an observation group and a control group according to the difference in intervention methods,each with 40 cases.The control group was given routine nursing,and the observation group was given outcome retrospective education combined with case management of intensive family follow-up.The cardiac function,exercise endurance,compliance behaviors,quality of life,psychological resilience,and the incidence of major adverse cardiovascular events(MACEs)were compared between the two groups.Results After 1 and 3 months of intervention,the left ventricular end-diastolic diameter(LVEDD)in the observation group was smaller than that in the control group.The left ventricular ejection fraction(LVEF)and the 6-min walk test(6MWT)were greater than those in the control group.The scores of the Seattle Angina Questionnaire(SAQ)and the Connor-Davidson Resilience scale(CD-RISC)were higher than those in the control group(all P<0.05).The above indicators in both groups were improved compared with those before intervention(all P<0.05).After 3 months of intervention,the above indicators in both groups were improved compared with those after 1 month of intervention(all P<0.05).The observation group had higher compliance rates of regular medication,balanced diet,appropriate physical activity,smoking cessation,alcohol withdrawal and regular follow-up,and had a lower total incidence of MACEs than the control group(all P<0.05).Conclusion Outcome retrospective education combined with case management model of intensive family follow-up can improve the cardiac function,exercise endurance,complianc

关 键 词：急性心肌梗死 经皮冠状动脉介入术 结局回溯性教育 强化家庭随访个案管理 心功能 

分 类 号：R473.5[医药卫生—护理学]