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目的:讨论西宁地区冠脉支架植入术(PCI)术后护理及冠状动脉支架再狭窄(ISR)因素分析。方法:将108例5年以上患有双支病变的高血压、糖尿病患者随机分为干预组、对照组各54例;干预组在常规治疗、护理基础上出院前对患者进行选择性、预防性的日常饮食护理教育,帮助改善饮食习惯,以限制动物脂肪、胆固醇的摄入量、选择低糖饮食、保持维生素和矿物质充足供给、保持适量运动;出院后每两个月采用电话的方式进行用药情况、血脂、血压、血糖监控情况,作息情况、饮食情况,戒烟、戒酒情况的跟踪随访并做好记录。随访4年观察发生ISR事件的发生相关因素及两组护理差异,并作统计学分析。结果:1吸烟、饮酒、高脂血症、高血压控制不理想是ISR的主要诱发因素;2通过有效的干预护理手段可以显著延长ISR事件的发生周期,延长患者生存时间,提高患者生活质量,在服药的依存性方面与对照组比较有显著差异;3护理干预手段与对照组比较可显著减少患者ISR事件的发生。结论:PCI患者应建立医患沟通机制,实施护理干预活动,对患者生存意志的加强,提高患者药物使用的依存性,减低ISR的发生率具有积极作用。
Objective: To discuss the nursing and coronary artery stent restenosis (ISR) after coronary stent implantation in Xining. Methods: 108 cases of hypertension and diabetes with double-vessel disease more than 5 years were randomly divided into intervention group and control group with 54 cases each. Patients in intervention group were selected for prophylaxis before discharge on the basis of routine treatment and nursing Of daily diet and nursing education to help improve eating habits, to limit animal fat and cholesterol intake, choose a low-sugar diet, to maintain adequate supply of vitamins and minerals, to maintain adequate exercise; discharged after every two months by telephone way to medication Follow-up of the situation, blood lipids, blood pressure, blood glucose monitoring, work and rest, diet, smoking cessation, alcohol withdrawal, and make a record. Followed up for 4 years to observe the incidence of ISR events related factors and nursing differences between the two groups, and for statistical analysis. The results showed that: 1, smoking, alcohol, hyperlipidemia, hypertension control is not ideal is the main predisposing factor of ISR; 2 effective intervention intervention can significantly prolong the occurrence of ISR events, extend patient survival and improve patient quality of life, There was a significant difference in medication dependency compared with the control group. (3) Compared with the control group, the nursing interventions could significantly reduce the occurrence of ISR events in patients. Conclusion: PCI should establish a communication mechanism between doctors and patients, and implement nursing interventions, which have a positive effect on strengthening the patients’ will to survive, improving their dependence on drugs and reducing the incidence of ISR.