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连续性精准护理在冠状动脉造影及支架植入术患者中的应用及效果评价:临床结局研究

The application and effect evaluation of continuity precision nursing in patients undergoing coronary angiography and stent implantation: A study of clinical outcomes.

作者信息

Tan Limin, Tan Xiaojing, Zhang Cangyun, Tao Lei, Liao Yuan

机构信息

Cardiovascular Medicine Center, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, Hubei, China.

出版信息

Medicine (Baltimore). 2025 Mar 21;104(12):e41879. doi: 10.1097/MD.0000000000041879.

Abstract

Coronary artery disease is a major global health burden, with percutaneous coronary intervention (PCI) serving as a key treatment strategy. Despite its efficacy, challenges such as in-stent restenosis, medication nonadherence, unhealthy lifestyles, and psychological distress hinder optimal recovery. Continuity-based precision nursing, which integrates personalized care and multidisciplinary support, offers a potential solution. Therefore, the purpose of this study is to evaluate the effectiveness of continuity-based precision nursing compared to conventional nursing in improving postoperative outcomes for PCI patients. This includes assessing its impact on cardiac function recovery, complication prevention, medication adherence, lifestyle modifications, psychological well-being, and overall quality of life. This study included 112 PCI patients treated from January 2023 to January 2024, divided into an experimental group (continuity-based precision nursing) and a control group (conventional nursing). Propensity score matching resulted in 45 matched pairs. Data collected included demographics, postoperative cardiac function, medication adherence, lifestyle changes, psychological status, complications, satisfaction, and health-related quality of life. Statistical analyses were performed using SPSS, with P < .05 considered significant. Continuity-based precision nursing showed significant benefits over conventional nursing. At 1 month post-PCI, the experimental group had higher left ventricular ejection fraction ≥ 50% rates (86.7% vs 75.6%) and lower in-stent restenosis (6.7% vs 17.8%) and residual stenosis rates (8.9% vs 24.4%, P = .048). Medication adherence was improved (86.7% vs 66.7%, P = .02), with higher rates eof smoking cessation (77.8% vs 55.6%, P = .01), healthy eating (84.4% vs 66.7%, P = .03), and regular exercise (80.0% vs 62.2%, P = .02). Anxiety and depression scores were significantly lower in the experimental group post-intervention. Patient satisfaction (92.5 ± 4.2 vs 85.7 ± 6.1, P < .01) and health-related quality of life (88.4 ± 5.0 vs 81.2 ± 6.0, P < .01) were also markedly higher. Continuity-based precision nursing significantly enhances postoperative outcomes in PCI patients, improving cardiac function, adherence, lifestyle behaviors, and psychological well-being. This model provides a comprehensive framework for coronary artery disease care, with potential for broader clinical application. Further research should evaluate its long-term impact and scalability in diverse settings.

摘要

冠状动脉疾病是一项重大的全球健康负担,经皮冠状动脉介入治疗(PCI)是关键的治疗策略。尽管其疗效显著,但诸如支架内再狭窄、药物治疗依从性差、不健康的生活方式和心理困扰等挑战阻碍了最佳康复。基于连续性的精准护理整合了个性化护理和多学科支持,提供了一种潜在的解决方案。因此,本研究的目的是评估与传统护理相比,基于连续性的精准护理在改善PCI患者术后结局方面的有效性。这包括评估其对心脏功能恢复、并发症预防、药物依从性、生活方式改变、心理健康和总体生活质量的影响。本研究纳入了2023年1月至2024年1月接受治疗的112例PCI患者,分为实验组(基于连续性的精准护理)和对照组(传统护理)。倾向得分匹配产生了45对匹配病例。收集的数据包括人口统计学资料、术后心脏功能、药物依从性、生活方式改变、心理状态、并发症、满意度以及与健康相关的生活质量。使用SPSS进行统计分析,P < 0.05被认为具有统计学意义。基于连续性的精准护理显示出比传统护理更显著的益处。PCI术后1个月,实验组左心室射血分数≥50%的比例更高(86.7%对75.6%),支架内再狭窄率更低(6.7%对17.8%),残余狭窄率更低(8.9%对24.4%,P = 0.048)。药物依从性得到改善(86.7%对66.7%,P = 0.02),戒烟率更高(77.8%对55.6%,P = 0.01),健康饮食率更高(84.4%对66.7好,P = 0.03),规律运动率更高(80.0%对62.2%,P = 0.02)。干预后实验组的焦虑和抑郁评分显著更低。患者满意度(92.5±4.2对85.7±6.1,P < 0.01)和与健康相关的生活质量(88.4±5.0对81.2±6.0,P < 0.01)也明显更高。基于连续性的精准护理显著改善了PCI患者的术后结局,改善了心脏功能、依从性、生活方式行为和心理健康。该模式为冠状动脉疾病护理提供了一个全面的框架,具有更广泛临床应用的潜力。进一步的研究应评估其在不同环境中的长期影响和可扩展性。

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