摘要
目的 探讨全球急性冠状动脉事件注册评分（GRACE）和出血风险评分（CRUSADE）在急性冠脉综合征（ACS）患者护理中的应用价值.方法 选择2015年3月—2016年5月就诊的128例拟行择期PCI治疗的ACS患者为研究对象,采用随机数字表法随机分为常规护理组（常规组,63例）和优化护理组（优化组,65例）.常规组根据目前护理规范进行ACS常规护理,优化组首先对其进行GRACE评分和CRUSADE评分,根据危险分层进行分层优化护理.记录和比较两组患者住院期间主要不良心脏事件（MACEs）、出血事件、平均住院天数和住院费用.结果 两组患者冠脉造影特征（多支病变比例、靶血管分布）和PCI操作过程（支架植入的部位、数量、长度、直径及支架植入后冠脉血流分级）比较,差异均无统计学意义（P〉0.05）.与常规组相比,优化组住院期间MACEs发生率和出血事件发生率有下降趋势,优化组患者住院时间有缩短趋势,但差异无统计学意义（P〉0.05）,优化组患者平均住院费用为（33491±1982）元,低于常规组的（36562±2395）元,差异有统计学意义（t=-7.914,P〈0.001）.结论 对拟行择期PCI的ACS患者,GRACE评分和CRUSADE评分指导下的分层优化护理,可提升ACS患者整体治疗效果,降低住院费用.
Objective To investigate the effects of global registry of acute coronary events （GRACE） and Can Rapid risk stratification of unstable angina patients suppress adverse outcomes with early implementation of the ACC/AHA guidelines（CRUSADE） score in the nursing care for patients with acute coronary syndrome （ACS）.Methods A total of 128 patients with ACS undergoing percutaneous coronary intervention （PCI） who were admitted from March 2015 to May 2016 were enrolled in this study and divided into usual care group （63 cases） and optimized care group （65 cases）. Patients in the usual care group received usual care according to the guidelines, while patients in the optimized care group received optimized care according to GRACE and CRUSADE score. The major adverse cardiac events, the incidence of bleeding complications, average hospitalization and hospitalization costs were recorded and compared between the two groups. Results The characteristics of angiography （multiple vessel rate and target vessel distribution） and procedures of PCI （position, number, length and diameter of stents, coronary blood flow classification after the implantation of stents） were similar （all P〉0.05）. There were tendencies of reduction in the incidence of MACE, bleeding complications and average hospitalization time in patients of optimized care group compared to the usual care group, with no statistically significant differences between the two groups （P〉0.05）. The hospitalization costs in the optimized care group （33491±1982）RMB were significantly less than those in the usual care group （36562±2395）RMB. The difference was statistically significant （t=-7.914,P〈0.001）.Conclusions Optimized care according to GRACE and CRUSADE can improve the treatment effects of ACS patients undergoing PCI and decrease the cost.
作者
张志联
董翠霞
牛晓叶
张琳
汪雁博
谷新顺
Zhang Zhilian Dong Cuixia Niu Xiaoye Zhang Lin Wang Yanbo Gu Xinshun(Nursing Department, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China)
出处
《中华现代护理杂志》
2017年第24期3088-3092,共5页
Chinese Journal of Modern Nursing
基金
2015年度河北省医学科学研究重点课题计划（20150667）
关键词
急性冠状动脉综合征
护理
经皮冠状动脉介入
全球急性冠状动脉事件注册评分
出血风险评分
Acute coronary syndrome
Nursing care
Percutaneous coronary intervention
Global registry of acute coronary events
Can rapid risk stratification of unstable angina patients suppress adverse outcomes with early implementation of the ACC/AHA guidelines
