精细化护理干预在冠心病介入术后造影剂肾病预防中的应用

摘要

目的 探讨精细化护理干预在冠心病介入术后造影剂肾病预防中的效果.方法 选择2013年1月至2016年1月本院行PCI术的住院患者136例.使用随机数表法分组,按照1∶1分为精细化护理干预、普通护理组.对比介入术后两组:患者对治疗及护理的满意度;发生造影剂肾病的数量;治疗前后尿量;血肌酐变化;急性冠脉闭塞、心律失常、皮下血肿、尿潴留等并发症.结果 精细化护理干预组与普通护理组在治疗前年龄、性别、血肌酐方面差异无统计学意义(P＞0.05).普通护理组治疗后血肌酐[(99.23±44.25)μmol/l比(81.22±20.44)μmol/l,P=0.015)]、造影剂肾病发生率(14.7％比2.9％,P=0.0 16)以及并发症发生率(33.8％比13.2％,P=0.005)均高于精细化护理组(P＜0.05).普通护理组患者对治疗及护理的满意度(82.4％比95.6％;P=0.014)、24 h尿量[(1 803.26±500.25) ml比(2 001.28±305.25) ml,P=0.033)]低于精细化护理组.结论 精细化护理干预在预防冠心病介入治疗术后造影剂肾病中,可提高患者及家属对治疗及护理的满意度,减少造影剂肾病的发生率,值得临床广泛推广.%Objective To investigate the effect of fine nursing intervention in the prevention of contrastinduced nephropathy after percutaneous coronary intervention (PCI).Methods 136 hospitalized patients undertaking PCI at our hospital from January,2013 to January,2016 were selected and were divided into a fine nursing intervention group and a general nursing group using random number table.The patients' satisfaction to treatment and nursing,the number of contrast induced nephropathy,urine volume before and after treatment,the change of serum creatinine before and after surgery,and complications,such as acute coronary occlusion,arrhythmia,subcutaneous hematoma,urinary retention,and so on were compared between these two groups.Results There were no statistical differences in age,sex,and serum creatinine between these two groups before the treatment (P ＞ 0.05).After the treatment,the serum creatinine [(99.23±44.25) μmol/l vs.(81.22±20.44) μmol/L,P=0.015],the incidence of contrast induced nephropathy (14.7％ vs.2.9％,P=0.016),and the incidence of complications (33.8％ vs.13.2％,P=0.005) were higher in the general nursing group than in the fine nursing intervention.The satisfaction to treatment and care (82.4％ vs.95.6％,P=0.014) and 24 hours urine volume [(1 803.26±500.25) ml vs.(2 001.28±305.25) ml,P=0.033] were lower in the general nursing group than in the fine nursing intervention.Conclusions Fine nursing intervention in the prevention of contrast nephropathy after coronary heart disease can improve patients' satisfaction to treatment and care and reduce the incidence of contrast-induced nephropathy,so it is worth being clinically generalized.