体外反搏对冠心病睡眠障碍患者睡眠及生活质量的影响研究

发布时间：2018-05-16 15:14

本文选题：冠心病 + 睡眠障碍　；参考：《郑州大学》2016年硕士论文

【摘要】：目的了解冠心病(coronary atherosclerotic heart disease,CAD)伴睡眠障碍患者的睡眠质量及其生活质量状况;观察体外反搏治疗对患者的睡眠质量和生活质量的影响,分析体外反搏治疗对冠心病伴睡眠障碍患者的干预效果。方法本研究为观察性研究。选取郑州市某三级甲等医院体外反搏治疗中心CAD伴睡眠障碍的患者42例为观察组,同时选取该院心内科病区42例CAD伴睡眠障碍患者为对照组。对照组接受冠心病常规治疗、护理和睡眠卫生相关的健康宣教;观察组在对照组基础上,给予体外反搏的干预措施。两组在相近的治疗条件和睡眠环境下进行观察。分别于两组干预前、干预1个月、干预结束后使用一般资料调查表、匹兹堡睡眠质量指数量表、冠心病生活质量调查表等量表进行调查评估,采用IBM SPSS Statistics 20.0软件对所得数据进行录入和统计分析,统计方法包括:描述性统计分析、卡方检验、独立样本t检验、非参数检验和重复测量方差分析,检验水准为α=0.05。结果1.干预前匹兹堡睡眠质量调查结果:最终共84例患者参与本研究,观察组42例,对照组42例。其中男性占42.86%,女性占57.14%,平均年龄为58.32±7.28。本研究所有CAD患者睡眠质量得分为1.98±0.60,64.29%的患者处于中度水平;入睡时间得分为2.24±0.53,64.29%的患者处于中度水平;睡眠时间得分为1.42±0.50,41.67%的患者处于中度水平;睡眠效率得分为0.93±0.67,80.95%的患者处于轻度水平;睡眠障碍得分为1.85±0.45,80.95%的患者处于中度水平;催眠药物使用得分为0.70±0.69,91.67%的患者处于轻度水平;日间功能得分为2.20±0.53,66.67%的患者处于中度水平;PSQI总分为11.31±2.02。得分高于国内成人PSQI调查常模,睡眠质量较差。2.干预前生活质量调查结果显示:生理功能得分均值为(28.82±4.84)分,心理功能得分均值为(31.21±5.83)分,社会支持得分均值为(34.24±5.11)分,冠心病特异指数为(45.58±4.74)生活质量总分得分均值为(139.86±10.81)分。3.干预前两组基线资料对比结果显示:观察组和对照组之间性别、年龄、婚姻状态、文化程度、职业类别、月收入和就医方式等一般人口学资料,患病年限、合并症、PCI术后期限和心功能分级等疾病一般资料差异均无统计学意义(P0.05)。观察组和对照组之间的PSQI得分、生活质量得分差异均无统计学意义。4.干预后PSQI结果显示:观察组和对照组患者干预前、干预一个月、干预结束后PSQI重复测量方差分析,在时间因素上比较可得研究对象睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、日间功能以及PSQI总分前后差异具有统计学意义(P0.01),即排除分组因素,CAD睡眠障碍患者的PSQI总分及其6个维度得分均随时间推移下降;在组别效应上睡眠质量、入睡时间、睡眠时间以及睡眠效率有统计学差异(P0.05),睡眠障碍、日间功能以及PSQI总分有显著差异(P0.01),即排除时间因素,干预方式的不同,CAD睡眠障碍患者的PSQI总分及其6个维度得分均下降程度不同;在三个时间点患者睡眠质量、入睡时间和睡眠障碍以及PSQI总分存在时间因素和分组因素的交互作用(P0.05)。催眠药物使用方面,观察组和对照组患者在三个时间点均不存在统计学差异(P0.05)。5.干预后生活质量结果显示:干预后观察组生理功能、心理功能、冠心病特异指数得分和生活质量总分高于对照组,差异有统计学意义(P0.05),社会功能得分两组之间不存在差异(P0.05)。结论1.CAD睡眠障碍患者睡眠及生活质量水平较差,并且睡眠状况和生活质量存在一定相关性。2.体外反搏治疗方法能有效改善CAD睡眠障碍患者的睡眠状况,改善患者的疾病症状,提高患者生活质量。
[Abstract]:Objective to investigate the quality of sleep and the quality of life in patients with coronary atherosclerotic heart disease (CAD) with sleep disorders, and to observe the effect of extracorporeal counterpulsation on the quality of sleep and the quality of life of the patients. The effect of extracorporeal counterpulsation on patients with coronary heart disease and sleep disorders was analyzed. Methods this study was an observational method. The study selected 42 cases of CAD with sleep disorder in a three grade a hospital in Zhengzhou. At the same time, 42 cases of CAD with sleep disorders in the Department of Cardiology were selected as the control group. The control group received coronary heart disease routine treatment, nursing and sleep hygiene related health education; the observation group was on the basis of the control group. The intervention measures were given for the external counterpulsation. The two groups were observed under the similar treatment conditions and sleep conditions. Before the intervention of the two groups, the two groups were intervened for 1 months. After the intervention, the general data questionnaire, the Pittsburgh sleep quality index scale, the coronary heart disease quality questionnaire isometric scale were evaluated, and the IBM SPSS Statistics 20 was used. The data were recorded and analyzed by the software, including descriptive statistical analysis, chi square test, independent sample t test, nonparametric test and repeated measurement of variance analysis. The test level was the results of the Pittsburgh sleep quality survey before intervention of alpha =0.05. 1.: the final total of 84 patients were involved in this study, 42 cases in the observation group, and the control group. Among the 42 cases, 42.86% were male and 57.14% for women, and the average age was 58.32 + 7.28.. All the patients with the sleep quality of 1.98 + 0.60,64.29% in all CAD patients were in moderate level; the patients who had a score of 2.24 + 0.53,64.29% in the sleep time were in moderate level; the patients who had a sleep time of 1.42 + 0.50,41.67% were in a moderate level; sleep was at a moderate level; sleep was moderate. The patients with a score of 0.93 + 0.67,80.95% of sleep efficiency were at a mild level; the patients with a sleep disorder score of 1.85 0.45,80.95% were in a moderate level; the patients with a score of 0.70 + 0.69,91.67% for hypnotic drugs were at a mild level; the patients with a daily functional score of 2.20 + 0.53,66.67% were at a moderate level, and the total score of PSQI was 11.31 + 2.02.. The results of the quality of life survey before.2. intervention in domestic adult PSQI showed that the average score of physiological function score was (28.82 + 4.84), the mean value of mental function score was (31.21 + 5.83), the mean of social support score was (34.24 + 5.11), and the cor heart disease specific index was (45.58 + 4.74), and the average score of the total score was (45.58 + 4.74). The comparison of baseline data between the two groups before.3. intervention showed that there was no significant difference in general demographic data between the observation group and the control group, such as sex, age, marital status, educational level, occupational category, monthly income and medical mode, and other diseases, such as the duration of illness, complication, the duration of PCI and the classification of heart function. (P0.05). The score of PSQI between the observation group and the control group had no significant difference in the score of life quality (.4.), and the outcome of PSQI showed that the observation group and the control group intervened one month before intervention, and the PSQI repeated the analysis of variance analysis after the intervention, and the sleep quality, time of sleep, and sleep were better than the time factors. The difference of sleep efficiency, sleep disorder, daytime function and PSQI total score was statistically significant (P0.01), that is to exclude group factors, the total score of PSQI and its 6 dimensions in CAD sleep disorders were all decreased with time, and there were statistical differences in sleep quality, sleep time, sleep time and sleep efficiency in group effect (P0.0 5) there were significant differences in sleep disorder, daytime function and PSQI total score (P0.01), that is, the difference of time factor and intervention, the total score of PSQI and its 6 dimensions in CAD sleep disorder patients were all decreased, and the time and group cause of sleep quality, sleep time and sleep disorder and PSQI total score at three time points. There was no statistical difference between the observation group and the control group at three time points (P0.05) in the use of hypnotic drugs (P0.05), the results of the quality of life in the three time points showed that the results of physiological function, psychological function, coronary heart disease specific index score and the total score of quality of life in the observation group were higher than those of the control group, and the difference was statistically significant. (P0.05) there is no difference between the scores of social function scores between the two groups (P0.05). Conclusion the sleep and life quality of patients with 1.CAD sleep disorder is poor, and there is a certain correlation between the sleep status and the quality of life. The.2. extracorporeal counterpulsation can effectively improve the sleep status of the patients with CAD sleep disorder, improve the symptoms of the patients and improve the patient's symptoms. Quality of life.

【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R473.5

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