2023 年第 5 期 第 18 卷

时间流程图在心房颤动合并冠心病及高血压病患者中的应用

Application of time flow chart in patients with atrial fibrillation combined with coronary atherosclerotic heart disease and hypertension

作者：周文悦马晓桦石继慧马艾刘畅刘玮桑才华马长生

英文作者：Zhou Wenyue Ma Xiaohua Shi Jihui Ma Ai Liu Chang Liu Wei Sang Caihua Ma Changsheng

单位：首都医科大学附属北京安贞医院心律失常中心一病区,北京100029

英文单位：First Ward of Arrhythmia Center Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：心房颤动；冠心病（冠状动脉粥样硬化性心脏病）；高血压病；时间护理流程图

英文关键词：Atrialfibrillation;Coronaryatheroscleroticheartdisease;Hypertension;Timenursingflowchart

• 摘要：

• 目的 探讨时间护理流程图对心房颤动合并冠心病（冠状动脉粥样硬化性心脏病）及高血压病患者在射频消融围手术期内血压、心功能及生活质量的影响。方法 选取首都医科大学附属北京安贞医院2020年10月至2021年10月收治的60例心房颤动合并冠心病及高血压病行射频消融患者，按照随机抽签法分为观察组和对照组，各30例。对照组围手术期予常规护理，观察组在此基础上予时间护理流程图干预。比较2组干预前后血压、心功能指标、护理依从性及生活质量。结果  干预后，2组收缩压、舒张压均低于干预前（均P＜0.05），且观察组均低于对照组［（124±11）mmHg（1 mmHg=0.133 kPa）比（135±12）mmHg、（81±8）mmHg比（90±6）mmHg］，观察组血压控制率高于对照组［96.7%（29/30）比73.3%（22/30）］（均P<0.05）。干预后2组左心室射血分数、最大摄氧量、6 min步行距离均高于/长于干预前，且观察组均高于/长于对照组（均P＜0.05）。干预后2组护理依从性中遵医用药、科学饮食、适量运动评分及简明健康状况调查量表中精神健康、生理功能、社会功能、总体健康评分均高于干预前，且观察组均高于对照组（均P＜0.05）。结论   时间护理流程图干预可提高心房颤动合并冠心病及高血压病患者射频消融围手术期血压控制率，促进心功能恢复，提高护理依从性并改善生活质量。

• Objective  To explore the effect of time nursing flow chart on blood pressure, cardiac function and quality of life in patients with atrial fibrillation (AF) combined with coronary atherosclerotic heart disease and hypertension during the perioperative period of radiofrequency ablation. Methods From October 2020 to October 2021, 60 patients with AF combined with coronary atherosclerotic heart disease and hypertension who received radiofrequency ablation in Beijing Anzhen Hospital, Capital Medical University were enrolled, and they were divided into observation group and control group according to random drawing method, with 30 cases in each group. During the perioperative period, the control group was given routine nursing, and the observation group was given time nursing flow chart intervention based on routine nursing. Blood pressure, cardiac function index, nursing compliance and quality of life between the two groups were compared before and after intervention. ResultsThe systolic blood pressure and diastolic blood pressure after intervention were lower than those before intervention in the two groups （both P＜0.05）, those in the observation group were lower than those in the control group［（124±11） mmHg vs （135±12） mmHg,（81±8） mmHg vs （90±6） mmHg］, and the blood pressure control rate in the observation group was higher than that in the control group ［96.7%（29/30） vs 73.3%（22/30）］（both P＜0.05）. The left ventricular ejection fraction, maximum oxygen uptake and 6 min walking distance after intervention were higher/longer than those before intervention in the two groups, and those in the observation group were higher/longer than those in the control group (all P<0.05). The scores of medication compliance, scientific diet, moderate exercise in nursing compliance and the scores of mental health, physiological function, social function and overall health in 36-item Short Form Health Survey scale after intervention were higher than those before intervention in the two groups, and those in the observation group were higher than those in the control group (all P<0.05). Conclusions The intervention of time nursing flow chart can improve the perioperative blood pressure control rate in patients with AF combined with coronary atherosclerotic heart disease and hypertension, promote the recovery of cardiac function, and improve nursing compliance and the quality of life.