CAJ | 학술논문

目的：了解急性心肌梗死（ AMI）行急诊PCI的患者血浆脑钠肽（ BNP）的水平，探讨护理方法及效果。方法选择130例因AMI行急诊PCI的患者，按照入院顺序分成干预组和对照组，每组各65例，对照组给予常规治疗及护理，干预组在此基础上根据测定BNP的水平进行危险分级，给予针对性护理干预，调查两组患者6个月内再发生不良心血管事件的情况，应用西雅图心绞痛生存质量测量量表（ SAQ）对两组患者生活质量情况进行评估。结果干预组再发生不良心血管事件（心力衰竭、心肌梗死、心律失常、心绞痛、心源性死亡）4例（6.2％），明显低于对照组15例（23.1％），两组比较差异有统计学意义（χ2＝7.45；P＜0.01）。干预组SAQ量表活动受限、心绞痛发作、心绞痛稳定、治疗满意度、主观感受各因子得分及量表总分分别为（79.69±11.87），（95.13±13.02），（91.32±11.05），（79.86±8.39），（74.12±14.18），（82.50±15.12）分，均高于对照组的（60.28±9.73），（84.60±10.89），（78.24±9.59），（68.21±7.45），（60.56±11.64），（69.45±13.26）分，两组比较差异有统计学意义（t值分别为8.02，5.23，5.95，7.14，7.88，6.45；P＜0.01）。结论根据急诊PCI患者血浆BNP的检测水平，实施护理干预可减少不良心血管事件的再发生率，提高其生活质量。
목적：료해급성심기경사（ AMI）행급진PCI적환자혈장뇌납태（ BNP）적수평，탐토호리방법급효과。방법선택130례인AMI행급진PCI적환자，안조입원순서분성간예조화대조조，매조각65례，대조조급여상규치료급호리，간예조재차기출상근거측정BNP적수평진행위험분급，급여침대성호리간예，조사량조환자6개월내재발생불양심혈관사건적정황，응용서아도심교통생존질량측량량표（ SAQ）대량조환자생활질량정황진행평고。결과간예조재발생불양심혈관사건（심력쇠갈、심기경사、심률실상、심교통、심원성사망）4례（6.2％），명현저우대조조15례（23.1％），량조비교차이유통계학의의（χ2＝7.45；P＜0.01）。간예조SAQ량표활동수한、심교통발작、심교통은정、치료만의도、주관감수각인자득분급량표총분분별위（79.69±11.87），（95.13±13.02），（91.32±11.05），（79.86±8.39），（74.12±14.18），（82.50±15.12）분，균고우대조조적（60.28±9.73），（84.60±10.89），（78.24±9.59），（68.21±7.45），（60.56±11.64），（69.45±13.26）분，량조비교차이유통계학의의（t치분별위8.02，5.23，5.95，7.14，7.88，6.45；P＜0.01）。결론근거급진PCI환자혈장BNP적검측수평，실시호리간예가감소불양심혈관사건적재발생솔，제고기생활질량。
Objective To investigate the plasma brain natriuretic peptide ( BNP ) levels in the acute myocardial infarction ( AMI) patients who undergone emergency percutaneous coronary intervention ( PCI) , and to explore the method and effect of nursing .Methods One hundred and thirty AMI patients with emergency PCI were divided into the intervention group and the control group according to the order of admission , each with 65 cases.The control group received the routine treatment and nursing , and the intervention group received the specific nursing intervention according to the level of BNP on the basis of the control .The major adverse cardiovascular events ( MACE) were investigated within the six months of follow-up, and the quality of life was evaluated by the Seattle angina questionnaire ( SAQ) in the two groups .Results The cases of MACE including heart failure, myocardial infarction, arrhythmia, angina pectoris, sudden cardiac death were four cases (6.2%) in the intervention group, and were significantly lower than fifteen cases (23.1%) in the control group, and the difference was statistically significant (χ2 =7.45;P <0.01 ) . The scores of SAQ including the activity limitation, the attack of angina pectoris , the stability of angina pectoris , treatment satisfaction , subjective feeling and total were respectively ( 79.69 ±11.87 ) , ( 95.13 ±13.02 ) , ( 91.32 ±11.05 ) , ( 79.86 ±8.39 ) , (74.12 ±14.18),(82.50 ±15.12) in the intervention group, and were higher than (60.28 ±9.73),(84.60 ± 10.89),(78.24 ±9.59),(68.21 ±7.45),(60.56 ±11.64),(69.45 ±13.26) in the control group, and the differences were statistically significant ( t =8.02,5.23,5.95,7.14,7.88,6.45, respectively; P <0.01 ). Conclusions According to the level of BNP in the patients with emergency PCI , the specific nursing intervention can reduce the incidence rate of MACE and improve the life quality of the patients .