目的:探讨团体认知行为疗法对二尖瓣置换术患者心理应激反应及心功能的影响。方法:将2019年1~12月南阳市中心医院心外科收治的二尖瓣置换术患者70例，应用随机数字表法分为观察组及对照组，各35例。对照组围术期行心外科常规性护理，观察组围术期实施团体认知行为疗法。比较两组干预前后的心理应激反应、心功能、应对方式、不良情绪及不良事件发生情况。结果:干预后观察组心理应激反应相关指标〔心率(HR)、呼吸频率(RR)、平均动脉压(MAP)、血糖水平、皮质醇、肾上腺素〕较对照组显著下降；干预后观察组左心室射血分数(LVEF)大于对照组；而左心室收缩末直径(LVIDs)、左心室舒张末期内径(LVIDD)小于对照组；干预后观察组焦虑评分、抑郁评分、回避、屈服评分低于对照组；而面对评分高于对照组；观察组不良心脏事件发生率及再入院率低于对照组，差异均有统计学意义(均 P<0.05)。 结论:团体认知行为疗法可促使二尖瓣置换术患者以积极的心态面对疾病，减轻患者不良情绪及心理应激反应，有助于改善患者的心功能，降低不良心脏事件，有利于患者术后康复。

Objective:To explore the effect of continuous care based on interactive education and scenario simulation on disease management ability and prognosis of patients after heart valve replacement.Methods:From January to December 2019, 68 cases of heart valve replacement patients admitted to the Department of Cardiology of Nanyang Central Hospital were selected and divided into observation group and control group according to random number table, with 34 patients in each group.The control group received routine continuing care after operation, while the observation group applied interactive education combined with scenario simulation to implement continuous care. The follow-up time was 6 months. The disease management ability, prognosis and quality of life were compared between the two groups.Results:After intervention, the total scores of dietary management, exercise, complication management, emotion management and disease management in the observation group were higher than those in the control group, and the differences were statistically significant( P<0.05). The incidence of myocardial infarction, angina pectoris, anticoagulant excessive bleeding and rehospitalization in the observation group were lower than those in the control group, and the differences were statistically significant ( P<0.05). After intervention, the total scores of physiological fields, psychological fields, independence fields, environment fields, social relations fields and quality of life in the observation group were higher than those in the control group, and the differences were statistically significant( P<0.05). Conclusions:Interactive education combined with scenario simulation can effectively improve the disease management ability of patients undergoing heart valve replacement surgery after discharge, reduce the rate of cardiovascular events and readmission, and improve the quality of life of patients.

目的:观察基于心脏康复风险评估的康复治疗联合中医经络操对冠状动脉支架植入术后疗效的影响.方法:将接受冠状动脉支架植入手术的患者98例按照随机数字表法分为对照和观察组各49例.对照组术后给予常规护理的基础上进行基于心脏康复风险评估的康复治疗;观察组在对照组的基础上实施经络操进行干预.比较2组干预前后汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分、临床症状评分及生活质量评分.结果:治疗干预后,2组HAMA、HAMD评分均较干预前降低(P＜0.05),且观察组2项评分均低于对照组(P＜ 0.05).治疗干预后,2组纳差、乏力、腹胀、肠鸣音异常等临床症状评分均较治疗前降低(P＜0.05),且观察组各项评分低于对照组(P＜0.05).治疗干预后,2组患者心理状态、生理状态、环境领域、社会关系等生活质量评分均较治疗前升高(P＜0.05),且观察组各项评分高于对照组(P＜0.05).结论:基于心脏康复风险评估的康复治疗联合经络操干预冠状动脉支架植入术后,有助于促进患者术后康复,改善症状及焦虑抑郁状态,提高生活质量.

目的 探讨医护一体化护理在老年瓣膜置换术患者中的应用效果.方法 选取2018年4月至2020年4月在我院行瓣膜置换术的老年心脏瓣膜病患者68例,随机分为两组各34例.对照组采用常规护理,实验组采用医护一体化护理,比较两组护理前后的生活质量及护理满意度.结果 护理后,两组的SF-36各维度评分均显著高于护理前,且实验组的SF-36各维度评分均显著高于对照组(P＜0.05).实验组的护理满意度为97.06％,显著高于对照组的79.41％(P＜0.05).结论 医护一体化护理可有效提高老年瓣膜置换术患者的生活质量及护理满意度,值得临床推广应用.