Effect of comprehensive geriatric assessment nursing on prognosis of elderly patients with coronary heart disease and angina pectoris after percutaneous coronary intervention
摘要 目的探讨老年综合评估（comprehensive geriatric assessment，CGA）护理对老年冠心病心绞痛患者经皮冠状动脉介入（percutaneous coronary intervention，PCI）术后预后的影响。方法选取86例老年冠心病心绞痛患者，均行PCI治疗；依据就诊时间的先后，将其分为常规护理组和CGA护理组，各43例。常规护理组给予常规护理，CGA护理组在常规护理基础上予以CGA护理。对比两组心功能［左心室舒张末期容积（left ventricular enddiastolic volume,LVEDV）、左心室射血分数（LVEF）、氨基末端脑钠肽前体（NT-proBNP）、6 min步行距离］，自护能力［冠心病自我管理行为量表（coronary artery disease selfmanagement behavior scale，CSMS）］，心理状态［焦虑自评量表（selfrating anxiety scale，SAS）］，生活质量［中国心血管病人生活质量评定问卷（China questionnaire of quality of life in patients with cardiovascular diseases，CQQC）］的改善情况和主要不良心血管事件（major adverse cardiovascular events,MACE）的发生情况及护理满意度。结果干预后，CGA护理组LVEF、LVEDV、6 min步行距离均高于常规护理组，NT-proBNP水平低于常规护理组（P＜0.05）；干预后CGA护理组CSMS评分、CQQC评分高于常规护理组，SAS评分低于常规护理组（P＜0.05）。干预期间，CGA护理组MACE发生率明显低于常规护理组（4.65% vs. 18.60%，P＜0.05）；CGA护理组护理满意度高于常规护理组（95.35% vs. 81.40%,P＜0.05）。结论CGA护理用于PCI术后老年冠心病心绞痛患者，可改善患者负性情绪状态，增强自我管理能力，促进心功能好转，减少MACE的发生，提高患者的生活质量及护理满意度。
Abstract：ObjectiveTo investigate the effect of comprehensive geriatric assessment (CGA) nursing on the prognosis of elderly patients with coronary heart disease (CHD) and angina pectoris after percutaneous coronary intervention (PCI). MethodsA total of 86 elderly patients with CHD and angina pectoris were selected, and all treated by PCI. They were divided into routine nursing group and CGA nursing group, with 43 cases in each group. The routine nursing group was given routine nursing while the CGA nursing group was given CGA nursing on the basis of routine nursing. We compared the improvement of cardiac function ［left ventricular enddiastolic volume (LVEDV), LVEF, NTproBNP and 6minute walking distance］, self-care ability ［coronary artery disease selfmanagement behavior scale (CSMS)］, mental state ［selfrating anxiety scale (SAS)］ and quality of life ［China questionnaire of quality of life in patients with cardiovascular diseases (CQQC)］, the occurrence of major adverse cardiovascular events (MACE), and nursing satisfaction between the two groups. ResultsAfter intervention, LVEF, LVEDV and 6minute walking distance in the CGA nursing group were all higher than those in the routine nursing group, while NT-proBNP level was lower than that in the routine nursing group (P<0.05). After intervention, CSMS and CQQC scores in the CGA nursing group were higher than those in the routine nursing group, while SAS score was lower than that in the routine nursing group (P<0.05). During the intervention, the incidence of MACE in the CGA nursing group was significantly lower than that in the routine nursing group (4.65% vs. 18.60%, P<0.05). Nursing satisfaction in the CGA nursing group was higher than that in the routine nursing group (95.35% vs. 81.40%, P<0.05). ConclusionAmong elderly patients with CHD and angina pectoris after PCI, CGA nursing could improve their negative emotional state, enhance self-management ability, promote the improvement of cardiac function, reduce the occurrence of MACE, and improve their quality of life and nursing satisfaction.
