标题：聚焦解决模式在冠心病经皮冠状动脉介入治疗患者中的应用

      作者：李大严，陈漠水，黎福理，郑晓莹，王在远    中南大学湘雅医学院附属海口医院心血管内科，海南 海口 570208

      卷次： 2020年31卷8期

      【摘要】 目的 观察聚焦解决模式在冠心病经皮冠状动脉介入治疗(PCI)患者中的应用效果。方法 选取2017年11月至2018年5月中南大学湘雅医学院附属海口医院心内科诊治的130例住院冠心病PCI术后患者，按照随机数表法分为对照组和观察组，每组65例。对照组给予常规护理，观察组在对照组的常规护理基础上给予聚焦解决模式护理干预，住院期间每周1次，出院后每两周复诊干预1次，干预3个月。应用焦虑自评量表(SAS)、抑郁自评量表(SDS)和生存质量测定量表简表 (QOL-BREF)评价两组患者干预前后的焦虑抑郁情绪和生存质量并进行比较，同时比较两组患者随访1年期间的主要心血管不良事件(MACE)发生情况。结果 干预后，两组患者的SAS和SDS评分较干预前明显降低，而且观察组患者的SAS和SDS评分明显低于对照组，差异均有统计学意义(P<0.05)；干预后，观察组患者的QOL-BREF总分、心理维度、生理维度、环境维度和社会关系维度评分较干预前明显升高，差异均有统计学意义(P<0.05)，而对照组患者仅QOL-BREF总分、心理维度、生理维度和环境维度明显高于干预前，差异均有统计学意义(P<0.05)；干预后，观察组患者的QOL-BREF总分、心理维度、生理维度、环境维度和社会关系维度评分明显高于对照组，差异均有统计学意义(P<0.05)；随访1年，观察组患者的MACE发生率为7.69%，明显低于对照组的 21.54%，差异有统计学意义(P<0.05)。结论 聚焦解决模式有助于改善经PCI术后冠心病患者的焦虑和抑郁情绪，提高生存质量，降低MACE发生率，值得临床推广。
      【关键词】 聚焦解决模式；冠心病；经皮冠状动脉介入术；情绪；生存质量；主要心血管不良事件
      【中图分类号】 R473.5 【文献标识码】 A 【文章编号】 1003—6350（2020）08—1082—04

Application of focused solution model in percutaneous coronary intervention in patients with coronary heartdisease.
LI Da-yan, CHEN Mo-shui, LI Fu-li, ZHENG Xiao-ying, WANG Zai-yuan. Department of Cardiovasology,Haikou Hospital Affiliated to Xiangya School of Medicine, Central South University, Haikou 570208, Hainan, CHINA
【Abstract】 Objective To observe the clinical effects of focused solution mode in patients with coronary heartdisease after percutaneous coronary intervention (PCI). Methods A total of 130 patients with coronary heart disease af-ter percutaneous coronary intervention (PCI), who admitted to Haikou Hospital Affiliated to Xiangya School of Medi-cine, Central South University from November 2017 to May 2018, were selected and divided into the control group andobservation group according to random number table method, with 65 patients in each group. The control group was giv-en routine nursing, while the observation group was given focused solution model nursing intervention on the basis ofthe routine nursing in the control group, once a week during hospitalization and once every two weeks after discharge,for three months. The self-rating anxiety scale (SAS), self-rating depression scale (SDS), and quality of life scale-ab-breviated version (QOL-BREF) were used to evaluate the changes of anxiety, depression and quality of life before andafter treatment. The anxiety, depression and quality of life were compared between the two groups before and after theintervention, and the occurrence of major adverse cardiac events (MACE) were recorded in the follow-up of one year.Results After intervention, the proportion of patients with anxiety and depression and the scores of SAS and SDS in theobservation group were significantly lower than those of the control group (all P<0.05); the scores of QOL-BREF, psycho-logical dimension, physiological dimension, environmental dimension and social relationship dimension in observationgroup were significantly higher than those before the intervention (all P<0.05); while the scores of QOL-BREF, psycholog-ical dimension, physiological dimension, and environmental dimension in control group were significantly higher thanthose before the intervention (all P<0.05). After intervention, the scores of QOL-BREF, psychological dimension, physio-logical dimension, environmental dimension, and social relationship dimension in the intervention group were significant-ly higher than those of in the control group (all P<0.05). After one year follow-up, the incidence of MACE in the observa-tion group was 7.69%, which was significantly lower than 21.54% of in the control group (P<0.05). Conclusion Focusedsolution model could improve anxiety and depression of patients with coronary heart disease after PCI, and improve thequality of life and reduce the incidence of MACE, which is worthy of clinical promotion.
      【Key words】 Focused solution model; Coronary heart disease; Percutaneous coronary intervention (PCI); Emo-tion; Quality of life; Major cardiovascular adverse events (MACE)·护理·doi:10.3969/j.issn.1003-6350.2020.08.038基金项目：海南省卫生计生行业科研项目(编号：18A200021)