标题：基于FMEA模式的康复护理在冠心病合并糖尿病患者PCI围术期的干预效果

      作者：王丹红 1，林凡菊 2，祝玮容 1    上海中医药大学附属曙光医院介入诊疗中心 1、传统医学康复治疗中心 2，上海 201203

      卷次： 2022年33卷20期

      【摘要】 目的 研究基于失效模式与效应分析(FMEA)模式的康复护理在冠心病合并糖尿病患者冠状动脉介入(PCI)围术期的干预效果。方法 选取上海中医药大学附属曙光医院2020年8月至2021年6月期间收治的60例均行PCI术的冠心病合并糖尿病患者作为研究对象，按随机数表法分为研究组和对照组，各30例。对照组患者采用常规护理，研究组患者采用基于FMEA模式的康复护理。两组患者均连续干预6个月，记录并比较两组患者在干预前后的收缩压(SBP)、舒张压(DBP)、空腹血糖(FPG)、餐后2 h血糖(2 hPG)水平，并采用健康调查量表(SF-36)评价两组患者的生活质量，同时比较两组患者的并发症发生率和对护理的满意度。结果 干预前，两组患者的SBP、DBP、FPG、2 hPG比较差异均无统计学意义(P>0.05)；干预后，两组患者的SBP、DBP、FPG、2 hPG水平均明显降低，且研究组患者的SBP、DBP、FPG、2 hPG水平分别为(132.48±6.02) mmHg、(84.95±2.36) mmHg、(7.63±1.27) mmol/L、(7.26±1.38) mmol/L，明显低于对照组的(152.56±5.89) mmHg、(93.46±2.18) mmHg、(8.59±1.58) mmol/L、(9.62±2.03) mmol/L，差异均有统计学意义(P<0.05)；干预6个月后，研究组患者的躯体功能、社会功能、认知功能、情绪功能、角色功能的评分分别为(73.58±7.54)分、(79.26±10.06)分、(72.08±8.06)分、(68.69±10.26)分、(77.63±9.06)分，明显高于对照组的(68.56±8.03)分、(72.57±9.68)分、(66.57±7.16)分、(63.57±8.62)分、(68.27±8.26)，差异均有统计学意义(P<0.05)；研究组患者的并发症发生率为3.33%，明显低于对照组的20.00%，患者对护理的满意度为93.33%，明显高于对照组的73.33%，差异均有统计学意义(P<0.05)。结论 冠心病合并糖尿病患者PCI围术期采用基于FMEA模式的康复护理，能有效控制患者的血压与血糖，降低患者并发症的发生率，提高患者的满意度与术后生活质量，具有临床应用价值。
      【关键词】 冠心病；糖尿病；冠状动脉介入术；失效模式与效应分析；围术期；康复护理；效果；生活质量
      【中图分类号】 R473.5 【文献标识码】 A 【文章编号】 1003—6350（2022）20—2680—04

Intervention effect of rehabilitation nursing based on failure mode and effect analysis model in patients withcoronary heart disease complicated with diabetes during perioperative period of percutaneous coronaryintervention.
WANG Dan-hong 1, LIN Fan-ju 2, ZHU Wei-rong 1. Intervention Center 1, Traditional Chinese MedicineRehabilitation Center 2, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai201203, CHINA
【Abstract】 Objective To study the intervention effect of rehabilitation nursing based on failure mode and ef-fect analysis (FMEA) model in the perioperative period of percutaneous coronary intervention (PCI) in patients with cor-onary heart disease and diabetes. Methods Sixty patients with coronary heart disease complicated with diabetes whounderwent PCI in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from August2020 to June 2021 were selected as the research objects. According to random number table method, they were randomlydivided into the study group and the control group, with 30 patients in each group. The patients in the control group re-ceived routine nursing, and the patients in the study group received rehabilitation nursing based on FMEA mode. Bothgroups were continuously intervened for 6 months. The systolic blood pressure (SBP), diastolic blood pressure (DBP),fasting blood glucose (FPG), and 2 h postprandial blood glucose (2 hPG) levels before and after the intervention were re-corded and compared between the two groups. The quality of life between the two groups was evaluated by health sur-vey scale (SF-36), and the incidence of complications and satisfaction with nursing were compared between the twogroups. Results Before the intervention, there was no significant difference in SBP, DBP, FPG, and 2 hPG between thetwo groups (P>0.05). After the intervention, the levels of SBP, DBP, FPG, and 2 hPG in the two groups decreased sig-nificantly, and the levels in the study group were (132.48±6.02) mmHg, (84.95±2.36) mmHg, (7.63±1.27) mmol/L,and (7.26±1.38) mmol/L, significantly lower than (152.56±5.89) mmHg, (93.46±2.18) mmHg, (8.59±1.58) mmol/L,and (9.62±2.03) mmol/L in the control group (P<0.05). After 6 months of intervention, the scores of physical function,　　　·护理·doi:10.3969/j.issn.1003-6350.2022.20.026基金项目：上海中医药大学附属曙光医院护理科研课题(编号：2019SGHL02)