认知行为干预结合预防性护理对冠心病患者PCI后焦虑抑郁及生活质量的影响

郝春颖; 杜健; 王雪; 宇南; 吕巍

doi:10.3969/j.issn.2096-3882.2020.11.014

摘要: 目的探讨综合护理对于行经皮冠状动脉支架植入术(PCI)后冠心病患者焦虑、抑郁情绪及生活质量的影响.方法选取120例住院治疗的冠心病患者作为研究对象,随机分为观察组(60例)与对照组(60例),对照组患者给予常规治疗和护理,观察组在此基础上给予认知行为干预和预防性护理.比较2组干预前后焦虑自评量表(SAS)、抑郁自评量表(SDS)、日常生活能力量表(ADL)、生活质量评分(SF-36)及西雅图心绞痛问卷(SAQ)评分的差异,并比较治疗前后2组患者主要不良心血管事件(MACE)发生率的差异.结果 2组干预前SAS、SDS评分的差异无统计学意义(P>0.05);观察组干预后SAS评分、SDS评分较对照组明显下降,差异有统计学意义(P<0.05).2组干预前SF-36、ADL、SAQ评分的差异无统计学意义(P>0.05),干预后2组SF-36、ADL、SAQ评分均显著增高,且干预组高于对照组,差异有统计学意义(P<0.05).观察组与对照组MACE发生率分别为5.00％和15.00％,差异有统计学意义(P<0.05).结论认知行为干预结合预防性护理对冠心病患者PCI后焦虑抑郁及生活质量有显著改善,效果明显,具有临床推广价值.

Abstract: Objective: Objective to investigate the effect of comprehensive nursing on anxiety, depression and quality of life in elderly patients with coronary heart disease (CHD) after percutaneous coronary intervention (CSI).Methods: 120 patients with coronary heart disease were selected as the research subjects. They were randomly divided into observation group (60 cases) and control group (60 cases). The control group was given conventional treatment and nursing, and the observation group was given cognitive behavior intervention in addition to routine treatment. Compared two groups of post nursing anxiety scale, self rating Depression Scale (SAS, SDS), daily living ability scale (ADL) score, quality of life score (SF-36) and Seattle angina pectoris questionnaire (SAQ). The blood glucose, blood lipid, blood pressure and the incidence of MACE were compared before and after treatment.Results: ① There was no significant difference in SAS and SDS scores before intervention between the two groups (P>0.05). The scores of SAS scores (43.18±8.23 vs. 51.21±8.21 points) and SDS (40.22±6.84 vs. 50.09±7.03 points) in the observation group decreased significantly between the observation group and the control group, and the difference was significant (P<0.05).② There was no significant difference in scores of SF-36, ADL and SAQ between the two groups on admission (P>0.05). After 6 months of intervention, the ADL, SF-36 and SAQ scores of the two groups were significantly higher (P<0.05); In comparison, the intervention group changed significantly, with significant differences (P<0.05);③ There were no significant differences in blood glucose, blood lipids, and blood pressure before treatment (P>0.05). After intervention for 6 months, they all improved significantly.④ The incidence of MACE was significantly different between the observation group and the control group (6.67%VS 15%) (P<0.05).Conclusion: Cognitive-behavioral intervention combined with preventive nursing has significantly improved anxiety, depression, and quality of life after CSI in elderly patients with coronary heart disease. The effect is significant and has clinical value