延續性護理對老年冠心病不穩定性心絞痛患者的護理效果及不良事件預防效果

霍向紅 周迎春

[摘要] 目的 探討延續性護理應用在冠心病不穩定性心絞痛中的臨床護理效果及應用價值。方法 方便選取2017年6月—2018年10月在該院接受治療老年冠心病不穩定性心絞痛患者190例，按照護理方法不同分為A組和B組，A組采取常規護理，B組采取延續性護理，對比兩組護理效果。結果B組干預后活動受限得分（83.55±5.76）分，心絞痛發作（92.54±5.89）分，治療滿意度（94.65±5.51）分，生活質量（85.13±5.76）分;A組干預后活動受限得分（71.32±4.65）分，心絞痛發作（80.76±4.91）分，治療滿意度（87.76±4.46）分，生活質量（73.65±3.54）分，組間對比差異有統計學意義（P<0.05）。B組發生頑固性心絞痛4例，急性心肌梗死3例，心律失常2例，心源性休克0例;A組發生頑固性心絞痛18例，急性心肌梗死13例，心律失常11例，心源性休克7例，組間對比差異有統計學意義（χ2=3.187 3、4.011 3、3.298 7、3.889 1，P<0.05）。結論 延續性護理應用在冠心病不穩定性心絞痛中可以提升患者生存質量，減少院外不良事件發生，值得在臨床推廣應用。

[關鍵詞] 延續性護理;老年;冠心病;不穩定性心絞痛;不良事件

[中圖分類號] R473? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1674-0742（2019）06（a）-0156-03

[Abstract] Objective To investigate the clinical nursing effect and value of continuity nursing in the unstable angina pectoris of coronary heart disease. MethodsA total of conveniently selected 190 patients with unstable angina pectoris were treated in our hospital from June 2017 to October 2018. They were divided into group A and group B according to the nursing methods， group A took regular nursing care， group B took continuous nursing care， and compared two groups of nursing effects. Results Group B had limited activity score （83.55±5.76）points， angina attack （92.54±5.89）points， treatment satisfaction （94.65±5.51）points， and quality of life （85.13±5.76）points; Group A had limited activity score （71.32±4.65）points， angina attack （80.76±4.91）points， treatment satisfaction （87.76±4.46）points， quality of life （73.65±3.54）points. The contrast between the groups was statistically significant （P<0.05）. There were 4 cases of intractable angina pectoris， 3 cases of acute myocardial infarction， 2 cases of arrhythmias and 0 cases of cardiogenic shock in group B. In group A， there were 18 cases of intractable angina pectoris， 13 cases of acute myocardial infarction， 11 cases of arrhythmias， and 7 cases of cardiogenic shock. There were statistically significant differences between groups （χ2=3.187 3， 4.011 3， 3.298 7， 3.889 1， P<0.05）. Conclusion Continuity nursing can improve the quality of life and reduce the occurrence of adverse events in patients with coronary heart disease in unstable angina pectoris.

[Key words] Continuity care; Old age; Coronary heart disease; Unstable angina; Adverse events

冠心病不穩定性心絞痛是臨床最為常見的慢性疾病，主要的發病原因是由于動脈粥樣硬化造成血管閉塞引發的心肌缺血、缺氧，隨著病情進展疾病反復發作，而且患者由于存在不良生活習慣如吸煙、服藥依從性差等會導致冠心病不斷惡化，影響了患者生活質量和生命安全[1]。近年來越來越多的研究注重對冠心病患者二級預防，常規護理僅關注患者在院內的護理，但是出院后則僅依靠電話隨訪方式進行觀察，隨著護理模式的轉變延續性護理在臨床廣泛應用，通過制定一系列護理措施實現了患者院外護理信息、護理管理、護患關系的延續過程，有助于改善患者健康狀況與功能狀態[2]。該研究方便選取2017年6月—2018年10月在該院接受治療老年冠心病不穩定性心絞痛患者190例按照護理模式不同分組，觀察不同護理方案對患者護理影響，以期為臨床提供指導和依據，現報道如下。