老年急性心肌梗死经皮冠状动脉介入治疗中预见性护理干预对心室颤动的影响

摘要

目的 探讨老年急性心肌梗死经皮冠状动脉介入治疗中预见性护理干预对心室颤动的影响.方法 选取我院2009年2月～2012年2月收治的经皮冠状动脉介入治疗老年急性心肌梗死患者192例,将其随机分为两组,采用常规护理患者96例为对照组,采用预见性护理患者96例为观察组.比较两组患者护理干预的临床疗效.结果 观察组舒张压、收缩压、血钾均低于对照组,观察组舒张末期左心室内径、左心室射血分数均小于对照组,但差异均无统计学意义(均P ＞ 0.05).观察组心率、住院时间均明显小于对照组,介入治疗成功率(99.0%)明显高于对照组(92.7%),心室颤动发生率(2.1%)明显低于对照组(9.4%),气管插管、心力衰竭、心室颤动、死亡等不良事件发生率均明显低于对照组,差异均有统计学意义(均P ＜ 0.05).结论 有效的预见性护理干预可以明显降低老年急性心肌梗死经皮冠状动脉介入治疗中心室颤动的发生率,提高经皮冠状动脉介入治疗的成功率.加强心理护理、开通静脉通路、及时补充血钾、有效的心电监护及救治配合是心室颤动抢救成功的关键.%Objective To investigate the influence of predictive nursing intervention on the percutaneous coronary intervention of aged myocardial infarction with ventricular fibrillation. Methods 192 aged myocardial infarction patients who treated with percutaneous coronary intervention were selected in the hospital from February 2009 to February 2012. Patients were randomly divided into two groups. 96 patients used conventional care as the control group. 96 patients used predictive nursing care as the observation group. Effect of nursing intervention were compared between two groups. Results Diastolic pressure, systolic blood pressure, serum potassium in the observation group were lower than those in the control group. Left ventricular end diastolic diameter, left ventricular ejection fraction in the observation group were less than those in the control group. The difference was not statistically significant (P > 0.05). Heart rate, time of hospitalization in the observation group were significantly smaller than those in the control group. Intervention success rate in the observation group (99%) was significantly higher than that in the control group (92.7%). The occurrence of ventricular fibrillation rate in the observation group (2.1%) was significantly lower than that in the control group (9.4%). Adverse events incidence of trachea! intubation, heart failure, ventricular fibrillation, death in the observation group were significantly lower than those in the control group. The difference was statistically significant (P < 0.05). Conclusion Effective predictive nursing intervention can significantly reduce ventricular fibrillation occurrence rate of aged myocardial infarction in the treatment with percutaneous coronary intervention?which can also increase the percutaneous coronary artery interventional therapy success rate. Strengthening psychological nursing, open venous pathway, timely replenishment of blood potassium, effective ECG moni-rntoring and treatment are the key to successful treatment of ventricular fibrillation.