标题：基于 IIFAR微信护理结合聚焦干预在急性心肌梗死PCI术后患者中的应用

      作者：蔡丹霞，郭燕，赵毅，陈士芳    河南科技大学第一附属医院心内科，河南 洛阳 471003

      卷次： 2024年35卷12期

      【摘要】 目的 探讨基于初始核对-信息交流-准确性核对-反应(IIFAR)微信护理结合聚焦干预在急性心肌梗死(AMI)经皮冠脉介入治疗(PCI)后的应用效果。方法 选取 2023年 1~4月河南科技大学第一附属医院收治的102例AMI患者纳入研究，按随机数表法分为对照组和观察组各 51例。两组患者均接受PCI术治疗，对照组采取常规干预，观察组于此基础上采取基于 IIFAR微信护理与聚焦干预相结合的管理模式，干预时间共 6个月。干预前和干预 2个月、6个月后，比较两组患者的冠心病自我管理行为量表(CSMS)评分、运动自我效能量表(SEE)评分，术后24 h内和干预2个月、6个月后，比较两组患者的心功能[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心房内径(LAD)]和运动能力[无氧阈耗氧量(VO2AT)、峰值耗氧量(VO2peak)、6 min步行距离(6MWD)]，并比较两组患者的主要不良心血管事件(MACE)发生情况。结果 干预2个月和6个月后，两组患者的CSMS和SEE评分均呈逐渐升高趋势，且观察组患者的CSMS、SEE评分明显高于对照组，差异均有统计学意义(P<0.05)；干预2个月和6个月后，两组患者的LVEF均呈逐渐升高趋势，而LVEDD、LAD均呈逐渐降低趋势，且观察组患者的LVEF明显高于对照组，LVEDD、LAD明显低于对照组，差异均有统计学意义(P<0.05)；干预2个月和6个月后，两组患者的VO2AT、VO2peak、6 MWD均呈逐渐升高趋势，且观察组患者的VO2AT、VO2peak、6 MWD明显高于对照组，差异均有统计学意义(P<0.05)；观察组患者的MACE总发生率为5.88%，略低于对照组的13.73%，但差异无统计学意义(P>0.05)。结论 基于 IIFAR微信护理结合聚焦干预有助于提高AMI PCI术后患者自我效能与自我管理能力，恢复心功能，提高运动能力。
      【关键词】 心肌梗死；初始核对-信息交流-准确性核对-反应；聚焦干预；心功能；运动能力；自我管理能力；自我效能；主要不良心血管事件
      【中图分类号】 R473.5 【文献标识码】 A 【文章编号】 1003—6350（2024）12—1803—06

Application of IIFAR-based WeChat nursing combined with focused intervention in patients after percutaneouscoronary intervention for acute myocardial infarction.
CAI Dan-xia, GUO Yan, ZHAO Yi, CHEN Shi-fang.Department of Cardiology, the First Affiliated Hospital of Henan University of Science and Technology, Luoyang 471003,Henan, CHINA
【Abstract】 Objective To explore the application effect of initial check-information exchange-final accuracycheck-reaction (IIFAR) WeChat nursing combined with focused intervention after percutaneous coronary intervention(PCI) for acute myocardial infarction (AMI). Methods A total of 102 patients with AMI admitted to the First AffiliatedHospital of Henan University of Science and Technology from January, 2023 to April, 2023 were selected for inclusionin the study. They were randomly divided into a control group and an observation group, with 51 patients in each group.Both groups received PCI treatment. The control group received conventional intervention, while the observation groupreceived a management model based on IIFAR WeChat nursing combined with focused intervention on this basis. The in-tervention time for both groups was six months. Before intervention, after 2 months, 6 months of intervention, the scoresof the Coronary Heart Disease Self-management Behavior Scale (CSMS) and the Self-efficacy for Exercise Scale (SEE)were compared between the two groups of patients. Within 24 hours after surgery, after 2 months, and after 6 months ofintervention, the cardiac function [left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter(LVEDD), left atrial diameter (LAD)] and exercise capacity [oxygen consumption at anaerobic threshold (VO2AT),peak oxygen consumption (VO2peak), 6-minute walk distance (6 MWD)] were compared between the two groupsof patients, and the incidence of major adverse cardiovascular events (MACE) was compared between the twogroups. Results After 2 months and 6 months of intervention, the CSMS and SEE scores of both groups showed agradual increase, and the CSMS and SEE scores of the observation group were significantly higher than those of the con-trol group, with statistically significant differences (P<0.05). After 2 months and 6 months of intervention, the LVEF ofboth groups showed a gradual increase, while LVEDD and LAD showed a gradual decrease; the LVEF of the observa-tion group was significantly higher than that of the control group, and LVEDD and LAD were significantly lowerthan those of the control group; the differences were statistically significant (P<0.05). After 2 months and 6 monthsof intervention, the VO2AT, VO2peak, and 6 MWD of both groups showed a gradual increase trend, and the three in-dexes of the observation group were significantly higher than those of the control group, with statistically signifi-cant differences (P<0.05). The total incidence of MACE in the observation group was 5.88%, slightly lower than13.73% of the control group (P>0.05). Conclusion IIFAR-based WeChat nursing combined with focused interven-tion helps improve self-efficacy and self-management, restore cardiac function, and improve exercise ability in AMI pa-tients after PCI.
      【Key words】 Myocardial infarction; Initial check-information exchange-final accuracy check-reaction; Focusedintervention; Heart function; Exercise ability; Self-management ability; Self-efficacy; Major adverse cardiac events