CAJ | 학술논문

目的：：探讨心脏再同步化起搏除颤器治疗扩张型心肌病伴恶性心律失常的护理方法及其效果。方法：将行心脏再同步化起搏除颤器治疗的扩张型心肌病伴恶性心律失常患者90例,随机分为对照组(常规护理)和观察组(护理干预)各45例。采用世界卫生组织生存质量测定量表( WHOQOL-BREF)评价2组患者治疗前后的生存质量,比较2组患者临床指标改变情况、疗效、心功能分级、术后不良事件发生情况和护理满意度。结果：2组患者治疗后左心室射血分数、6 min 步行距离、WHOQOL-BREF评分(生理领域、心理领域、社会领域、环境领域)均显著增加(P<0.01),而QRS波宽度、左心室舒张末期内径均显著降低(P<0.01)。观察组患者左心室射血分数、6 min步行距离均明显大于对照组(P<0.01),QRS波宽度、左心室舒张末期内径均明显小于对照组(P<0.01)；观察组患者WHOQOL-BREF评分(生理领域、心理领域、社会领域、环境领域)、总有效率、护理满意度均明显高于对照组(P<0.05~P<0.01),心功能分级状况明显优于对照组(P<0.01)；2组患者术后不良事件发生率差异无统计学意义(P>0.05)。结论：扩张型心肌病伴恶性心律失常患者行心脏再同步化起搏除颤器治疗时,有效的护理干预可改善患者的心功能,提高患者的生活质量。
목적：：탐토심장재동보화기박제전기치료확장형심기병반악성심률실상적호리방법급기효과。방법：장행심장재동보화기박제전기치료적확장형심기병반악성심률실상환자90례,수궤분위대조조(상규호리)화관찰조(호리간예)각45례。채용세계위생조직생존질량측정량표( WHOQOL-BREF)평개2조환자치료전후적생존질량,비교2조환자림상지표개변정황、료효、심공능분급、술후불량사건발생정황화호리만의도。결과：2조환자치료후좌심실사혈분수、6 min 보행거리、WHOQOL-BREF평분(생리영역、심리영역、사회영역、배경영역)균현저증가(P<0.01),이QRS파관도、좌심실서장말기내경균현저강저(P<0.01)。관찰조환자좌심실사혈분수、6 min보행거리균명현대우대조조(P<0.01),QRS파관도、좌심실서장말기내경균명현소우대조조(P<0.01)；관찰조환자WHOQOL-BREF평분(생리영역、심리영역、사회영역、배경영역)、총유효솔、호리만의도균명현고우대조조(P<0.05~P<0.01),심공능분급상황명현우우대조조(P<0.01)；2조환자술후불량사건발생솔차이무통계학의의(P>0.05)。결론：확장형심기병반악성심률실상환자행심장재동보화기박제전기치료시,유효적호리간예가개선환자적심공능,제고환자적생활질량。
Objective:To investigate the nursing method and effects in the dilated cardiomyopathy complicated with malignant arrhythmia patients treated with cardiac resynchronization pacing defibrillator. Methods:Ninety patients with the dilated cardiomyopathy complicated with malignant arrhythmia treated with cardiac resynchronization pacing defibrillator were randomly divided into the control group(treatment with routine care) and observation group(treatment with nursing intervention)(45 cases each group). The quality of life in two groups was evaluated by WHO quality of life scale(WHOQOL-BREF) before and after treatment. The changes of clinical indicators,treatment effect, heart function classification, postoperative adverse events and satisfaction were compared between two groups. Results:The LVEF,6 min walking distance,WHOQOL-BREF score(including physical field,psychological field,social field and environment field) in two groups after treatment were significantly higher than those in before treatment(P<0. 01),but the QRS wave width and LVEDD after treatment were significantly lower than those in before treatment(P<0. 01). The LVEF and 6 min walking distance in observation group were significantly larger than those in control group(P <0. 01),the QRS wave width and LVEDD in observation group were significantly less than those in control group(P<0. 01). The WHOQOL-BREF score(including physical field, psychological field,social field and environment field) ,total effective rate and nursing satisfaction in observation group were significantly higher than those in control group(P<0. 05 to P<0. 01). Heart function classification in observation group was significantly better than that in control group(P<0. 01). The difference of the incidence of postoperative adverse events between two groups was not statistically significant(P>0. 05). Conclusions:When the patients with dilated cardiomyopathy complicated with malignant arrhythmia are treated with cardiac resynchronization pacing defibrillator,the effective nursing intervention can significantly improve heart function and quality of life.