综合护理干预在静脉滴注硝酸甘油治疗急性心肌梗死中的应用效果

doi:10.3760/cma.j.issn.1007-1245.2024.24.035

摘要/Abstract

摘要：

目的　探讨分析综合护理干预在静脉滴注硝酸甘油治疗急性心肌梗死中的应用效果。方法　选取2021年6月至2023年6月郑州颐和医院心血管内科收治的120例急性心肌梗死患者，采用随机数字表法分为参照组与试验组，每组60例。参照组男31例、女29例，年龄（53.78±8.23）岁，发病时间（6.06±2.15）h。试验组男28例、女32例，年龄（53.81±8.14）岁，发病时间（6.11±2.32）h。两组均给予静脉滴注硝酸甘油治疗。在此基础上，参照组实施常规护理；试验组实施综合护理干预，包括心理干预、环境干预、饮食护理、并发症预防以及康复护理。两组护理干预时长从患者接受静脉滴注硝酸甘油治疗开始，直至治疗结束。对比两组干预前后负性情绪评分、自我护理能力、生活质量以及并发症发生情况。采用χ²检验、t检验进行统计分析。结果　干预后，试验组的焦虑自评量表评分、抑郁自评量表评分均低于参照组［（35.05±3.52）分比（46.49±4.43）分、（36.11±3.32）分比（45.21±4.92）分］，差异均有统计学意义（t=11.554、9.265，均P<0.001）；试验组的健康认知、自我概念、自我护理、自我责任感、心理功能、社会功能、物质生活状态、躯体症状评分分别为（22.05±2.52）分、（21.05±2.32）分、（21.72±2.23）分、（22.76±2.61）分、（72.05±6.52）分、（74.11±6.32）分、（75.12±6.23）分、（74.12±6.23）分，参照组上述指标分别为（18.49±2.03）分、（19.01±2.92）分、（18.80±2.81）分、（19.01±2.26）分、（65.49±5.43）分、（64.21±5.92）分、（66.30±5.11）分、（65.16±5.61）分，两组上述指标比较，差异均有统计学意义（t=8.521、4.237、6.305、8.413、5.988、8.855、8.478、8.278，均P<0.001）。试验组并发症发生率低于参照组［5.0%（3/60）比16.7%（10/60）］（χ²=4.227，P=0.040）。结论　在静脉滴注硝酸甘油治疗急性心肌梗死的患者中实施综合护理干预，能够有效降低患者的心理负担，促进病情恢复，提高患者的自我护理能力和生活质量，降低并发症发生风险，改善预后。

关键词:

急性心肌梗死, 硝酸甘油, 综合护理干预, 自我护理能力, 生活质量, 并发症

Abstract:

Objective　To explore the application effect of comprehensive nursing intervention in acute myocardial infarction treated by intravenous infusion with nitroglycerin. Methods　A total of 120 patients with acute myocardial infarction admitted to Cardiovascular Medicine Department, Zhengzhou Yihe Hospital from June 2021 to June 2023 were selected and were divided into a reference group and an experimental group by the random number table method, with 60 cases in each group. In the reference group, there were 31 males and 29 females, aged (53.78±8.23) years, and the onset time was (6.06±2.15) h. There were 28 males and 32 females in the experimental group, aged (53.81±8.14) years, and the onset time was (6.11±2.32) h. Both groups were given intravenous infusion with nitroglycerin. On the basis, the reference group was given routine nursing, and the experimental group was given comprehensive nursing intervention, including psychological intervention, environmental intervention, diet nursing, complication prevention, and rehabilitation nursing. The duration of nursing intervention in the two groups began from patients receiving intravenous infusion with nitroglycerin to the end of treatment. The negative emotion scores, self-care abilities, and qualities of life before and after intervention and complications were compared between the two groups. χ² test and t test were used. Results　After intervention, the scores of Self-rating Anxiety Scale and Self-rating Depression Scale in the experimental group were lower than those in the reference group [(35.05±3.52) points vs. (46.49±4.43) points, (36.11±3.32) points vs. (45.21±4.92) points] (t=11.554 and 9.265, both P<0.001). The scores of health cognition [(22.05±2.52) points], self-concept [(21.05±2.32) points], self-care [(21.72±2.23) points], self-responsibility [(22.76±2.61) points], psychological function [(72.05±6.52) points], social function [(74.11±6.32) points], material life status [(75.12±6.23) points], and somatic symptoms [(74.12±6.23) points] in the experimental group were higher than those in the reference group [(18.49±2.03), (19.01±2.92), (18.80±2.81), (19.01±2.26), (65.49±5.43), (64.21±5.92), (66.30±5.11), and (65.16±5.61) points], with statistically significant differences (t=8.521, 4.237, 6.305, 8.413, 5.988, 8.855, 8.478, and 8.278, all P<0.001). The complication rate of the experimental group was lower than that of the reference group [5.0% (3/60) vs. 16.7% (10/60)] (χ²=4.227, P=0.040). Conclusion　In patients with acute myocardial infarction treated by intravenous infusion with nitroglycerin, comprehensive nursing intervention can effectively reduce the patients' psychological burden, promote the recovery of the disease, improve the patients' self-care ability, improve the quality of life, reduce the risk of complications, and improve the prognosis.

Key words:

Acute myocardial infarction, Nitroglycerin, Comprehensive nursing intervention, Self-care ability, Quality of life, Complications

刘敏杰甘亚玮王咏丽吉闪闪卢双双.

综合护理干预在静脉滴注硝酸甘油治疗急性心肌梗死中的应用效果 [J]. 国际医药卫生导报, 2024, 30(24): 4236-4240.

Liu Minjie, Gan Yawei, Wang Yongli, Ji Shanshan, Lu Shuangshuang.

Application effect of comprehensive nursing intervention in acute myocardial infarction treated by intravenous infusion with nitroglycerin [J]. International Medicine and Health Guidance News, 2024, 30(24): 4236-4240.

参考文献

[1] 白鹏,杜晓艳,马波江,等. 尼可地尔对急性心肌梗死患者急诊经皮冠状动脉介入治疗术后无复流及心功能的影响[J]. 贵州医药,2021,45(6):881-882. DOI:10.3969/j.issn.1000-744X.2021.06.016.
[2] 宋歌,褚迎辉,张瑜,等. 基于时机理论的综合护理干预对急性心肌梗死PCI术后患者的影响[J]. 齐鲁护理杂志,2024,30(4):160-162. DOI:10.3969/j.issn.1006-7256.2024. 04.052.
[3] 唐宇红. 综合护理干预在老年糖尿病伴急性心肌梗死患者中的应用[J]. 中外医学研究,2024,22(1):106-110. DOI:10.14033/j.cnki.cfmr.2024.01.027.
[4] 褚红霞,任润梅.系统性护理干预对急性心肌梗死并发心律失常患者康复时间与安全性的影响研究[J].实用心脑肺血管病杂志,2021,29(S1):184-186.
[5] Shen Y, Zhu N, Bian W, et al. Observation on the application effect of stressor perception and response meticulous nursing in the perioperative period of acute myocardial infarction[J]. Altern Ther Health Med, 2024, 30(1): 63-67.
[6] Huang X. Individual nursing promotes rehabilitation of patients with acute myocardial infarction complicated with arrhythmia[J]. Am J Transl Res, 2021, 13(8): 9306-9314.
[7] Hou F, Xie T, Xi Y, et al. Effect of comprehensive psychological intervention on negative emotions and quality of life in patients with acute myocardial infarction[J]. Int Heart J, 2023, 64(6): 986-992. DOI: 10.1536/ihj.23-111.
[8] 中华医学会心血管病学分会,中华心血管病杂志编辑委员会,«中国循环杂志»编辑委员会. 急性心肌梗死诊断和治疗指南[J]. 中华心血管病杂志,2001,29(12):710-725. DOI:10.3760/j:issn:0253-3758.2001.12.003.
[9] 胡明南. 优化急救护理措施对急性心肌梗死患者抢救效果及生存质量的影响[J]. 山西医药杂志,2021,50(14):2245-2247. DOI:10.3969/j.issn.0253-9926.2021.14.045.
[10] 张婕,武彩虹,沈晓霞,等. 身心全面系统干预对急性心肌梗死合并左心衰竭患者PCI术后情绪波动的影响分析[J]. 河北医药,2021,43(21):3290-3292,3296. DOI:10.3969/j.issn.1002-7386.2021.21.022.
[11] 郝婉冰. 综合护理干预在老年高血压合并急性心肌梗死患者护理中的应用效果研究[J]. 中华养生保健,2023,41(19):161-163. DOI:10.3969/j.issn.1009-8011.2023.19.050.
[12] Chen J, Xu W, Cai X, et al. Nursing model based on Snyder's hope theory in emergency care of patients with acute myocardial infarction[J]. Am J Transl Res, 2023, 15(7): 4770-4778.
[13] Zhang Q, Yu Y. Effects of graded emergency nursing on resuscitation outcomes, prognosis, and nursing satisfaction in patients with acute myocardial infarction[J]. Am J Transl Res, 2021, 13(9): 10586-10592.
[14] 裴理辉,贾亚南,贾英岚. 基于正强化理论的护理干预在急性心肌梗死PCI术后患者中的应用效果[J]. 中华现代护理杂志,2022,28(30):4237-4241. DOI:10.3760/cma.j.cn115682-20220218-00742.
[15] 陈佳洁,朱渊,沈兰. 以时机理论为基础的家庭护理干预对急性心肌梗死患者生活质量的影响[J]. 实用临床医药杂志,2021,25(11):101-105. DOI:10.7619/jcmp.20201925.
[16] 张倩倩,臧舒婷,耿延花,等.血管通路选择和护理干预对急性心肌梗死患者的焦虑、抑郁情绪的影响[J].国际精神病学杂志,2022,49(05):933-936.DOI:10.13479/j.cnki.jip.2022.05.025.
[17] Liu X, Zou Y, Huang D, et al. Effect of evidence-based nursing combined with exercise rehabilitation in patients with acute myocardial infarction after percutaneous coronary intervention[J]. Am J Transl Res, 2022, 14(10): 7424-7433.
[18] Zhou Y, Wang X, Lan S, et al. Application of evidence-based nursing in patients with acute myocardial infarction complicated with heart failure[J]. Am J Transl Res, 2021,13(5): 5641-5646.
[19] 张利娜.综合护理干预在急性心肌梗死患者PCI术围手术期中的应用效果[J].现代诊断与治疗,2020,31(17):2835-2837.
[20] 许海霞.急性心肌梗死病人采用硝酸甘油进行治疗的效果以及护理措施研究[J].北方药学,2021,18(3):83-84.DOI:10.3969/j.issn.1672-8351.2021.03.042.
[21] 刘冰.综合护理干预对老年急性心肌梗死患者PCI术后康复的影响分析[J].中国医药指南,2021,19(21):135-136,139.DOI:10.15912/j.cnki.gocm.2021.21.062.
[22] 黄梅. 综合护理模式在重症监护病房急性心肌梗死护理中的应用研究[J]. 心血管病防治知识,2023,13(2):87-90. DOI:10.3969/j.issn.1672-3015(x).2023.02.028.
[23] 陈祥莺,陈祥燕,王婉茹. 急性心肌梗死合并糖尿病患者的临床护理研究[J]. 糖尿病新世界,2023,26(1):122-125. DOI:10.16658/j.cnki.1672-4062.2023.01.122.