护理干预在植入式心脏复律除颤器患者中的应用及效果

目的 探讨护理干预在植入式心脏复律除颤器（ICD）患者中的应用及效果.方法 选择湖州市中心医院2010年1月～2013年6月因致命性室性心律失常住院患者50例,随机分为观察组与对照组,每组各25例.对照组患者给予常规护理,观察组患者在对照组基础上应用护理干预模式,采用自我护理能力实施量表（ESCA）及日常生活质量评价量表（QOL）对患者出院后6个月自我护理能力及生活质量进行评价.结果 ①50例患者均恢复良好,其中有40例室性心动过速（VT）发作51次,10例心室颤动（VF）发作15次,均被ICD成功治疗.②观察组出院后6个月在ESCA总分、自我护理技能、自我护理责任感、自我概念、健康知识水平等项均明显高于对照组,差异均有统计学意义（均P＜ 0.05）.③观察组患者治疗后6个月生活质量评分中食欲、睡眠、精神、对疾病的认识、对治疗的态度、日常生活、家庭理解与配合等项目均高于对照组,差异均有统计学意义（均P＜ 0.05）.结论 合适的护理措施在心脏复律除颤器联合胺碘酮治疗致命性心律失常的效果较佳,可明显改善患者日常生活质量.

Applicantion and effect of nursing intervention in patients with implanted cardioverter defibrillator

Objective To investigate the nursing of cardioversion defibrillator combined with Amiodarone in the treatmnent of lethal arrhythmia.Methods 50 cases of lethal arrhythmia from January 2010 to June 2013 in Huzhou Central Hospital were selected and divided into observation group and control group,with 25 cases in each group.The control group were treated with routine nursing,the observation group were treated with nursing intervention mode combined with routine nursing.The effect of treatment and nursing was analyzed.ESCA scale and QOL scale were used to evaluate the self-care ability and life quality 6 months after leaving hospital.Results ①All the 50 patients were recovered well,51 times of VT were found in 40 patients,15 times of VF were found in l0 patients,all of them were cured by ICD successfully.②The total score of ESCA,self nursing skills,self nursing responsibility,self-concept and health knowledge level 6 months after leaving hospital in observation group were all higher than those in control group,the differences were statistically significant （all P ＜ 0.05）.③The life quality score indexes such as appetite,sleeping,mental state,awareness of the disease,attitude towards treatment,daily life,family understanding and cooperation 6 months after leaving hospital in observation group were all higher than those in control group,the differences were statistically significant （all P ＜ 0.05）.Conclusion Cardioversion defibrillator combined with Amiodarone and appropriate nursing measures has good therapeutic effect in the treatment of lethal arrhythmia,it can improve the daily life quality.