發(fā)布時(shí)間：2018-05-16 15:14

  本文選題：冠心病 + 睡眠障礙　； 參考：《鄭州大學(xué)》2016年碩士論文

【摘要】：目的了解冠心病(coronary atherosclerotic heart disease,CAD)伴睡眠障礙患者的睡眠質(zhì)量及其生活質(zhì)量狀況;觀察體外反搏治療對(duì)患者的睡眠質(zhì)量和生活質(zhì)量的影響,分析體外反搏治療對(duì)冠心病伴睡眠障礙患者的干預(yù)效果。方法本研究為觀察性研究。選取鄭州市某三級(jí)甲等醫(yī)院體外反搏治療中心CAD伴睡眠障礙的患者42例為觀察組,同時(shí)選取該院心內(nèi)科病區(qū)42例CAD伴睡眠障礙患者為對(duì)照組。對(duì)照組接受冠心病常規(guī)治療、護(hù)理和睡眠衛(wèi)生相關(guān)的健康宣教;觀察組在對(duì)照組基礎(chǔ)上,給予體外反搏的干預(yù)措施。兩組在相近的治療條件和睡眠環(huán)境下進(jìn)行觀察。分別于兩組干預(yù)前、干預(yù)1個(gè)月、干預(yù)結(jié)束后使用一般資料調(diào)查表、匹茲堡睡眠質(zhì)量指數(shù)量表、冠心病生活質(zhì)量調(diào)查表等量表進(jìn)行調(diào)查評(píng)估,采用IBM SPSS Statistics 20.0軟件對(duì)所得數(shù)據(jù)進(jìn)行錄入和統(tǒng)計(jì)分析,統(tǒng)計(jì)方法包括:描述性統(tǒng)計(jì)分析、卡方檢驗(yàn)、獨(dú)立樣本t檢驗(yàn)、非參數(shù)檢驗(yàn)和重復(fù)測(cè)量方差分析,檢驗(yàn)水準(zhǔn)為α=0.05。結(jié)果1.干預(yù)前匹茲堡睡眠質(zhì)量調(diào)查結(jié)果:最終共84例患者參與本研究,觀察組42例,對(duì)照組42例。其中男性占42.86%,女性占57.14%,平均年齡為58.32±7.28。本研究所有CAD患者睡眠質(zhì)量得分為1.98±0.60,64.29%的患者處于中度水平;入睡時(shí)間得分為2.24±0.53,64.29%的患者處于中度水平;睡眠時(shí)間得分為1.42±0.50,41.67%的患者處于中度水平;睡眠效率得分為0.93±0.67,80.95%的患者處于輕度水平;睡眠障礙得分為1.85±0.45,80.95%的患者處于中度水平;催眠藥物使用得分為0.70±0.69,91.67%的患者處于輕度水平;日間功能得分為2.20±0.53,66.67%的患者處于中度水平;PSQI總分為11.31±2.02。得分高于國(guó)內(nèi)成人PSQI調(diào)查常模,睡眠質(zhì)量較差。2.干預(yù)前生活質(zhì)量調(diào)查結(jié)果顯示:生理功能得分均值為(28.82±4.84)分,心理功能得分均值為(31.21±5.83)分,社會(huì)支持得分均值為(34.24±5.11)分,冠心病特異指數(shù)為(45.58±4.74)生活質(zhì)量總分得分均值為(139.86±10.81)分。3.干預(yù)前兩組基線資料對(duì)比結(jié)果顯示:觀察組和對(duì)照組之間性別、年齡、婚姻狀態(tài)、文化程度、職業(yè)類別、月收入和就醫(yī)方式等一般人口學(xué)資料,患病年限、合并癥、PCI術(shù)后期限和心功能分級(jí)等疾病一般資料差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。觀察組和對(duì)照組之間的PSQI得分、生活質(zhì)量得分差異均無統(tǒng)計(jì)學(xué)意義。4.干預(yù)后PSQI結(jié)果顯示:觀察組和對(duì)照組患者干預(yù)前、干預(yù)一個(gè)月、干預(yù)結(jié)束后PSQI重復(fù)測(cè)量方差分析,在時(shí)間因素上比較可得研究對(duì)象睡眠質(zhì)量、入睡時(shí)間、睡眠時(shí)間、睡眠效率、睡眠障礙、日間功能以及PSQI總分前后差異具有統(tǒng)計(jì)學(xué)意義(P0.01),即排除分組因素,CAD睡眠障礙患者的PSQI總分及其6個(gè)維度得分均隨時(shí)間推移下降;在組別效應(yīng)上睡眠質(zhì)量、入睡時(shí)間、睡眠時(shí)間以及睡眠效率有統(tǒng)計(jì)學(xué)差異(P0.05),睡眠障礙、日間功能以及PSQI總分有顯著差異(P0.01),即排除時(shí)間因素,干預(yù)方式的不同,CAD睡眠障礙患者的PSQI總分及其6個(gè)維度得分均下降程度不同;在三個(gè)時(shí)間點(diǎn)患者睡眠質(zhì)量、入睡時(shí)間和睡眠障礙以及PSQI總分存在時(shí)間因素和分組因素的交互作用(P0.05)。催眠藥物使用方面,觀察組和對(duì)照組患者在三個(gè)時(shí)間點(diǎn)均不存在統(tǒng)計(jì)學(xué)差異(P0.05)。5.干預(yù)后生活質(zhì)量結(jié)果顯示:干預(yù)后觀察組生理功能、心理功能、冠心病特異指數(shù)得分和生活質(zhì)量總分高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05),社會(huì)功能得分兩組之間不存在差異(P0.05)。結(jié)論1.CAD睡眠障礙患者睡眠及生活質(zhì)量水平較差,并且睡眠狀況和生活質(zhì)量存在一定相關(guān)性。2.體外反搏治療方法能有效改善CAD睡眠障礙患者的睡眠狀況,改善患者的疾病癥狀,提高患者生活質(zhì)量。
[Abstract]:Objective to investigate the quality of sleep and the quality of life in patients with coronary atherosclerotic heart disease (CAD) with sleep disorders, and to observe the effect of extracorporeal counterpulsation on the quality of sleep and the quality of life of the patients. The effect of extracorporeal counterpulsation on patients with coronary heart disease and sleep disorders was analyzed. Methods this study was an observational method. The study selected 42 cases of CAD with sleep disorder in a three grade a hospital in Zhengzhou. At the same time, 42 cases of CAD with sleep disorders in the Department of Cardiology were selected as the control group. The control group received coronary heart disease routine treatment, nursing and sleep hygiene related health education; the observation group was on the basis of the control group. The intervention measures were given for the external counterpulsation. The two groups were observed under the similar treatment conditions and sleep conditions. Before the intervention of the two groups, the two groups were intervened for 1 months. After the intervention, the general data questionnaire, the Pittsburgh sleep quality index scale, the coronary heart disease quality questionnaire isometric scale were evaluated, and the IBM SPSS Statistics 20 was used. The data were recorded and analyzed by the software, including descriptive statistical analysis, chi square test, independent sample t test, nonparametric test and repeated measurement of variance analysis. The test level was the results of the Pittsburgh sleep quality survey before intervention of alpha =0.05. 1.: the final total of 84 patients were involved in this study, 42 cases in the observation group, and the control group. Among the 42 cases, 42.86% were male and 57.14% for women, and the average age was 58.32 + 7.28.. All the patients with the sleep quality of 1.98 + 0.60,64.29% in all CAD patients were in moderate level; the patients who had a score of 2.24 + 0.53,64.29% in the sleep time were in moderate level; the patients who had a sleep time of 1.42 + 0.50,41.67% were in a moderate level; sleep was at a moderate level; sleep was moderate. The patients with a score of 0.93 + 0.67,80.95% of sleep efficiency were at a mild level; the patients with a sleep disorder score of 1.85 0.45,80.95% were in a moderate level; the patients with a score of 0.70 + 0.69,91.67% for hypnotic drugs were at a mild level; the patients with a daily functional score of 2.20 + 0.53,66.67% were at a moderate level, and the total score of PSQI was 11.31 + 2.02.. The results of the quality of life survey before.2. intervention in domestic adult PSQI showed that the average score of physiological function score was (28.82 + 4.84), the mean value of mental function score was (31.21 + 5.83), the mean of social support score was (34.24 + 5.11), and the cor heart disease specific index was (45.58 + 4.74), and the average score of the total score was (45.58 + 4.74). The comparison of baseline data between the two groups before.3. intervention showed that there was no significant difference in general demographic data between the observation group and the control group, such as sex, age, marital status, educational level, occupational category, monthly income and medical mode, and other diseases, such as the duration of illness, complication, the duration of PCI and the classification of heart function. (P0.05). The score of PSQI between the observation group and the control group had no significant difference in the score of life quality (.4.), and the outcome of PSQI showed that the observation group and the control group intervened one month before intervention, and the PSQI repeated the analysis of variance analysis after the intervention, and the sleep quality, time of sleep, and sleep were better than the time factors. The difference of sleep efficiency, sleep disorder, daytime function and PSQI total score was statistically significant (P0.01), that is to exclude group factors, the total score of PSQI and its 6 dimensions in CAD sleep disorders were all decreased with time, and there were statistical differences in sleep quality, sleep time, sleep time and sleep efficiency in group effect (P0.0 5) there were significant differences in sleep disorder, daytime function and PSQI total score (P0.01), that is, the difference of time factor and intervention, the total score of PSQI and its 6 dimensions in CAD sleep disorder patients were all decreased, and the time and group cause of sleep quality, sleep time and sleep disorder and PSQI total score at three time points. There was no statistical difference between the observation group and the control group at three time points (P0.05) in the use of hypnotic drugs (P0.05), the results of the quality of life in the three time points showed that the results of physiological function, psychological function, coronary heart disease specific index score and the total score of quality of life in the observation group were higher than those of the control group, and the difference was statistically significant. (P0.05) there is no difference between the scores of social function scores between the two groups (P0.05). Conclusion the sleep and life quality of patients with 1.CAD sleep disorder is poor, and there is a certain correlation between the sleep status and the quality of life. The.2. extracorporeal counterpulsation can effectively improve the sleep status of the patients with CAD sleep disorder, improve the symptoms of the patients and improve the patient's symptoms. Quality of life.

【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R473.5

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