基于LACE风险模型构建的出院干预计划在急性心肌梗死中的应用研究

发布时间：2018-10-29 08:38

【摘要】：[目的]本研究通过基于LACE风险预测模型构建针对急性心肌梗死患者的出院干预计划方案,并评价其在临床上的应用效果。[方法]本研究通过引入LACE风险预测模型,基于该风险预测模型构建急性心肌梗死患者的出院干预计划,根据预实验结果及相关专家提出的建议对出院干预计划进行修订。采取方便抽样方法选择2016年1月至2016年6月在江苏大学附属医院心血管科首次就诊的AMI患者120例。将入住的120例AMI患者应用随机数余数分组法进行随机化分组,干预组与对照组各60例,其中对照组采用传统管理模式拟定出院干预计划,干预组患者在住院期间评估患者及家属存在的各种健康问题及需求,提供契合的健康教育及护理措施,出院前进行LACE指数评分,根据评分提供冠心病二级预防相关内容的指导与随访计划。入组时收集患者一般基本资料,出院后6个月收集研究对象生存质量情况、冠心病自我行为管理、心功能判定及非计划重返率。[结果]成功随访107例,干预组54例,对照组53例。其中干预组患者非计划重返率及心脏不良事件发生率低于对照组(P0.05),干预组患者心功能改善情况优于对照组(P0.05),干预组患者自我管理行为(除急救管理外)情况优于对照组(P0.05),干预组患者生存质量优于对照组(P0.05)。[结论]考虑AMI患者存在的风险因素,基于LACE指数风险预测模型构建的出院干预计划,可降低非计划重返率与心脏不良事件发生率,改善AMI患者心功能,提高患者自我管理行为与生存质量,提升医疗安全与质量管理。
[Abstract]:[objective] based on LACE risk prediction model, we constructed an intervention plan for patients with acute myocardial infarction (AMI) and evaluated its clinical application. [methods] by introducing the LACE risk prediction model, the discharge intervention plan of patients with acute myocardial infarction was constructed based on the risk prediction model, and the intervention plan was revised according to the results of pre-experiment and the recommendations of relevant experts. From January 2016 to June 2016, 120 AMI patients were selected from the Cardiovascular Department of affiliated Hospital of Jiangsu University. One hundred and twenty patients with AMI were randomly divided into two groups: the intervention group (n = 60) and the control group (n = 60). The patients in the intervention group were assessed the health problems and needs of the patients and their families during hospitalization, and provided appropriate health education and nursing measures. The patients were evaluated with LACE index before discharge. Provide guidance and follow-up plan according to the score of coronary heart disease secondary prevention. The basic data of the patients were collected at the time of admission, and the quality of life, self-behavior management of coronary heart disease, cardiac function and unplanned return rate were collected 6 months after discharge. [results] 107 cases were followed up successfully, 54 cases in the intervention group and 53 cases in the control group. The unplanned re-entry rate and incidence of adverse cardiac events in the intervention group were lower than those in the control group (P0.05), and the improvement of cardiac function in the intervention group was better than that in the control group (P0.05). The self-management behavior (except emergency management) in the intervention group was better than that in the control group (P0.05), and the quality of life in the intervention group was better than that in the control group (P0.05). [conclusion] considering the risk factors of AMI patients, the discharge intervention plan based on LACE index risk prediction model can reduce the rate of unplanned re-entry and the incidence of adverse cardiac events, and improve the cardiac function of AMI patients. Improve patient self-management behavior and quality of life, improve medical safety and quality management.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.5

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