高龄心绞痛患者PCI治疗效果、安全性及护理研究

目的探讨高龄心绞痛患者经皮冠状动脉介入(PCI)治疗效果和安全性以及临床护理要点.方法选择接受PCI治疗的80岁及以上高龄冠心病不稳定型心绞痛患者81例(高龄组)和同期接受PCI治疗的40~60岁不稳定型心绞痛患者247例(中年组).对所有患者术前及术后实施整体护理,比较两组患者的患病危险因素、Syntax评分、植入支架的数量及长度、近期效果和主要并发症,并提出护理要点.结果高龄组与中年组高血压、糖尿病、高血脂患病率比较,差异均具有统计学意义(P0.01);两组患者的三支冠状动脉病变、Syntax评分、完全再血管化率、植入支架的数量和长度、出血性并发症和主要心脏不良事件(MACE)比较,差异均具有统计学意义(P0.05);靶血管TIMIⅢ级血流、急性或亚急性血栓、脑卒中和死亡发生率比较,差异均无统计学意义(P0.05).结论高龄冠心病心绞痛患者接受PCI治疗的近期效果和安全性与中年组无差异,整体护理是保证高龄患者围手术期康复的重要条件.

Effectiveness,Safety and Nursing Research on Percutaneous Coronary Intervention in Older Patients with Angina Pectoris

Objective To study the effectiveness, safety and nursing of percutaneous coronary intervention ( PCI) in the older patients with angina pectoris. Method 81 cases in the age of more than 80 year-old with unstable angina pectoris ( older group ) and 247 cases in the age from 40 to 60 year-old with unstable angina pectoris ( middle aged-group) were treated by PCI. All the patients were implemented the holistic nursing during in-hospital,and the nursing points were summarized. The risk factors, syntax score of coronary lesions, number and length of the stents implanted, recent effectiveness and major complication were comparatively evaluated. Results The susceptibility factors (hypertension,diabetes,hyperlipidemia) in the older group and the middle-aged were significantly different (P<0. 01). Three vessel coronary lesions,Syntax score of coronary lesions,the number and length implanted stents, rates of complete revascularization, hemorrhagic complications and major adverse cardiac events (MACE) were significantly different between the two groups (P<0. 05). The flow rate of target vessel TIMI 3,acute or subacute thrombosis,stroke and death showed no significantly difference between the two groups (P>0. 05). Conclusion The recent effectiveness and safety in the older patients with unstable angina pectoris are the same as those of the middle-aged group. Holistic nursing is the important condition to ensure perioperative rehabilitation for elderly patients.