行为干预对颈动脉狭窄支架植入患者预后的影响

目的探讨行为干预对颈动脉狭窄支架植入术后患者缺血性脑血管病复发率、颈动脉狭窄再发生率及生活质量的影响。方法选取济宁医学院附属医院2017年1月至2018年7月间收治的60例实施颈动脉狭窄支架植入术的患者作为研究对象,采取随机数字表法分为行为干预组和对照组。对照组实施颈动脉支架植入术后的常规随访,行为干预组在对照组干预基础上增加健康管理团队的随访、宣教、指导支架植入相关脑血管病危险因素的控制及检测。两组患者分别在干预前、干预后6个月、干预后12个月评估自我管理水平和生活质量。结果干预后12个月内,行为干预组(6.7%,3.3%)缺血性脑血管病复发率和颈动脉再狭窄发生率明显低于对照组(30.0%,20.0%)(均P<0.05)。干预后6个月及干预后12个月,干预组自我管理能力评分干预组:干预后6个月(171.20±18.43)分,干预后12个月(179.90±14.34)分;对照组:干预后6个月(160.77±13.43)分;干预后12个月(164.27±14.85)分]、生活质量评分干预组:干预后6个月(188.47±16.25)分,干预后12个月(203.17±13.84)分;对照组:干预后6个月(170.67±15.82)分;干预后12个月(183.80±18.19)分]高于对照组,差异有统计学意义(均P<0.05)。结论对颈动脉狭窄支架植入患者实施行为干预可有效减少脑卒中的复发率并降低颈动脉狭窄的再发生率,改善患者预后。其机制可能与行为干预可以提高颈动脉狭窄支架植入患者的自我管理能力和提高生活质量水平有关。

Effect of behavioral intervention on the prognosis of patients with carotid artery stenting

Objective To explore the effects of behavior intervention on patients with ischemic cerebrovascular disease recurrence,carotid artery stenosis recurrence,and quality of life after carotid artery stenting implantation.Methods Sixty patients with carotid stenosis who underwent stenting surgery between January 2017 and July 2018 in Affiliated Hospital of Jining Medical University were recruited.The subjects were randomly divided into behavioral intervention group and control group.The control group was routinely followed up after carotid artery stenting implantation.The behavioral intervention group added home visit,education,guidance of the control and detection of risk factors for cerebrovascular disease of stent implantation.Results After 12 months of intervention,the incidence of ischemic cerebrovascular disease and the recurrence rate of carotid restenosis in the behavioral intervention group(6.7%,3.3%)were significantly lower than those in the control group(30.0%,20.0%)(both P<0.05).Six months after the intervention and 12 months after the intervention,the self-management ability score(intervention group:six months after the intervention(171.20±18.43),12 months after the intervention(179.90±14.34);control group:six months after the intervention(160.77±13.43);12 months after the intervention(164.27±14.85))and quality of SS-QOL score(intervention group:6 months after intervention(188.47±16.25),12 months after intervention(203.17±13.84);control group:6 months after intervention(170.67±15.82);12 months after intervention(183.80±18.19)of the intervention group were higher than that of the control group,the difference is statistically significant(all P<0.05).Conclusion Behavioral intervention after carotid artery stenting implantation can effectively reduce the incidence of stroke and the recurrence rate of carotid stenosis and improve the prognosis of patients.The mechanism may be related with that the behavioral intervention can improve the self-management ability and the quality of life of patients with carotid stenosis.