摘要目的 探讨出院后护理干预能否预防冠心病患者急性心脏事件(acute cardiac events,ACE).方法 依据随机数字法将304例冠心病患者随机分为两组,对照组153例给予常规出院指导,观察组151例在此基础上进行出院后护理干预.随访3年,观察ACE发生情况.结果 对照组149例完成研究,观察组144例完成研究,完成研究的293例中ACE总发生率为32.4％.观察组ACE时间分布区曲线较低且相对平缓,对照组曲线在出院9个月后有随着时间延长而上升趋势；到观察终点时,观察组累计ACE发生率明显低于对照组(22.9％比41.6％),差异有统计学意义(x2=11.680,P＜0.05).与对照组相比,观察组接受经皮冠状动脉介入治疗者较少(8.3％比18.8％,x2=6.101),住院次数减少(20.1％比35.6％,x2=8.652),平均住院时间缩短[(8.83±3.43)比(11.36±3.13)d,t=-3.381],总病死率降低(3.5％比9.4％,x2 =4.237),差异均有统计学意义(P均＜0.05).结论 出院后护理干预能够减少冠心病患者ACE发生.

abstractsObjective To explore the effect of care intervention after hospital discharge on the acute cardiac events (ACE) prevention for patients with coronary heart disease (CHD).Methods A total of 293 patients with coronary heart disease were randomly divided into two groups,the control group (n =149) received routine discharge guidance,and the observation group (n =144) received care intervention on the basis of routine discharge guidance.They were followed up three years regularly,and the ACE onset in two groups were observed and compared.Results During the three years' follow-up,the total incidence of ACE was 32.4％.In the observation group,time distribution curve of ACE was relatively low and flat,while nine months after discharge,the curve in the control group had an upward trend with time extending.At the endpoint,the cumulative incidence of ACE in the observation group ( 22.9％ ) was lower than that in the control group (41.6％ ),and the difference was statistically significant ( x2 =11.680,P ＜ 0.05 ).The proportion of patients received percutaneous coronary intervention for ACE (8.3％ vs 18.8％,x2 =6.101 ),hospitalization proportion (20.1％ vs 35.6％,x2 =8.652 ),hospital stay [ (8.83 ± 3.43 ) days vs ( 11.36 ± 3.13 ) days,t =- 3.381 ],total mortality ( 3.5％ vs 9.4％,x2 =4.237 ) in the observation group were lower than those in the control group,and the differences were statistically significant( P ＜0.05 ).Conclusions Care intervention after hospital discharge can reduce ACE for patients with CHD.