综合护理干预在老年房颤病人第二代冷冻球囊消融术中的应用

doi:10.3969/j.issn.1003-9198.2021.11.024

摘要/Abstract

摘要： 目的探讨综合护理干预在老年房颤病人第二代冷冻球囊消融术中的应用效果。方法入选我院2019年8月至2020年12月行第二代冷冻球囊消融术治疗的房颤病人106例,随机分为试验组(53例)和对照组(53例)。试验组实施综合护理干预,对照组给予常规护理。观察并随访2组病人术前及术后焦虑程度、术中疼痛数字评分、术中不良反应发生率、术中镇痛药物使用剂量及术后对护理工作的满意度等指标。结果试验组术前及术后焦虑评分、术中疼痛数字评分、术中芬太尼使用剂量均显著低于对照组(P<0.05或P<0.01);病人术后对护理工作的满意度明显高于对照组(P<0.05);但2组术中迷走神经反射发生率、恶心呕吐发生率差异无统计学意义(P>0.05)。结论对行第二代冷冻球囊消融术的老年房颤病人实施综合护理干预,可减轻病人术前及术后焦虑情绪,有效降低术中因冷冻消融引起的胸痛程度,减少术中镇痛药物用量,提高病人对护理工作的满意度。

关键词: 综合护理干预, 第二代冷冻球囊导管消融术, 房颤, 老年人

Abstract: Objective To explore the effect of comprehensive nursing intervention in the elderly patients with atrial fibrillation undergoing the second-generation cryoballoon ablation(CBA). Methods A total of 106 elderly patients with atrial fibrillation undergoing second-generation CBA from August 2019 to December 2020 in Nanjing First Hospital were randomly assigned to the experimental group and the control group with 53 cases in each group. Patients enrolled in the experimental group received comprehensive nursing intervention, and those in the control group received conventional nursing care. Anxiety scores at preoperation and postoperation, pain scores during intraoperation, the incidence of adverse effect, the dosage of analgesic drugs and the patients' postoperative satisfaction with nursing work were compared between the two groups. Results The anxiety scores, the pain scores and the dosage of Fentanyl in the experimental group were significantly lower than those in the control group (all P<0.05 or P<0.01). There were no significant differences in the incidence rate of intraoperative vagus nerve reflex, nausea and vomiting between the two groups (P>0.05). The patients in the experimental group were more satisfied with nursing work than those in the control group (P<0.05). Conclusions Comprehensive nursing intervention for elderly patients with atrial fibrillation undergoing second-generation CBA might reduce periprocedural anxiety,alleviate CBA procedure-related chest pain, reduce the dosage of intraoperative analgesic and improve the patient's satisfaction with our nursing work.

Key words: comprehensive nursing intervention, second-generation cryoballoon ablation, atrial fibrillation, aged

中图分类号:

R 472.3

佘莉萍, 吴亚峰, 李绍满, 林松. 综合护理干预在老年房颤病人第二代冷冻球囊消融术中的应用[J]. 实用老年医学, 2021, 35(11): 1203-1206.

SHE Li-ping, WU Ya-feng, LI Shao-man, LIN Song. Application of comprehensive nursing intervention in elderly patients with atrial fibrillation undergoing second-generation cryoballoon ablation[J]. Practical Geriatrics, 2021, 35(11): 1203-1206.

参考文献

[1] KUCK K H, BRUGADA J, FURNKRANZ A, et al. Cryoballoon or radiofrequency ablation for paroxysmal atrial fibrillation[J]. N Engl J Med,2016,374(23):2235-2245.
[2] 黄从新.第二代冷冻球囊导管消融治疗心房颤动的研究进展[J]. 中华心律失常学杂志,2015,19(3):189-191.
[3] 汪向东,王希林,马弘,等.心理卫生评定量表手册(增订版)[M].北京:中国心理卫生杂志社,1999:205-209.
[4] 刘冬华,徐凌忠. 疼痛评估工具的选择及应用研究进展[J]. 全科护理, 2014,12(3):200-202.
[5] 中华医学会麻醉学分会老年人麻醉与围术期管理学组, 中华医学会麻醉学分会疼痛学组国家老年疾病临床医学研究中心, 国家老年麻醉联盟.老年患者围手术期多模式镇痛低阿片方案中国专家共识(2021版)[J]. 中华医学杂志, 2021, 101(3):170-184.
[6] Australian and New Zealand society for geriatric medicine position statement abstract: pain in older people[J]. Australas J Ageing,2016, 35(4):293.
[7] IGAWA-SILVA W, WU S, HARRIGAN R.Music and cancer pain management[J]. Hawaii Med J,2007,66(11):292-295.
[8] KETELS S, HOUBEN R, VANBEEUMEN K, et al. Incidence timing, and characteristics of acute changes in heart rate during ongoing circumferential pulmonary vein isolation[J]. Europace,2008,10(12):1406-1414.
[9] NAKAGAWA H, SCHERLAG B J, PATTERSON E, et al. Pathophysiologic basis of autonomic ganglinoated plexus ablation in patients with artial fibrillation[J]. Heart Rhythm,2009,6 (12 Suppl):S26-S34.
[10] 晏慧琳,卢小楠.心理护理对骨科手术患者认知以及焦虑的影响[J]. 中国健康心理学杂志,2018,26(1): 48-50.
[11] 涂红珍,张小艳.心理护理对骨科患者术前焦虑情绪的影响[J]. 全科口腔医学电子杂志,2019,6(17):141-150.
[12] 潘雅琴,王锦华,黄亚男,等.舒适护理联合优质护理在慢性阻塞性肺气肿老年患者中的应用观察[J]. 中国药物与临床, 2018,18(12):2251-2252.

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