| ObjectiveBy observing the cognitive behavioral intervention before and after coronary artery bypass grafting (CABG) in patients with anxiety, depression, and postoperative catheter indwelling time, guardianship, hospitalization time, explore the cognitive behavioral intervention on hemodynamic and cardiac function recovery of patients with CABG, provide the basis for perfecting CABG preoperative nursing care plan.MethodsThis research for the case-control study.66cases of coronary heart disease parallel CABG patients admitted in cardiac surgery were recruited from A Third-level First-class central Hospital heart surgical department from March,2012to December,2013.They were randomly divided into the control group (30cases) and the intervention group (36cases). All patients were no operation contraindication. Comparing the two groups in gender, age, grade of cardiac function and complications and so on, there was no significant difference (P>0.05), with comparable. The control group was given routine nursing, the intervention group received cognitive behavioral intervention on the basis of routine care, including cognitive therapy and behavior therapy. Compared2groups of patients24hours after admission,12h before surgery and72hours after surgery of anxiety, depression and postoperative indwelling time, ICU care and hospitalization time, hemodynamic parameters were measured daily using the United States Bioz Com noninvasive hemodynamic monitor, and then compared between two groups a day before operation and3days after to evaluate cardiac function. The influence of cognitive behavior intervention on patients’cardiac function with anxiety, depression after CABG was analyzed. Data analysis was completed using statistical software SPSS17.0. Measurement data was displayed as mean±standard deviation (x±s), and analyzed using the t test, count data was analyzed using Chi-square (χ2) test.Results1. Comparison of the psychological state of two groups of patients before and after intervention1.1The scores of SAS and SDS in the control group and the intervention group before intervention were not statistically significant; after intervention, the scores of SDS and SAS were significantly lower than those in the control group, the difference was statistically significant (P<0.05)2.Comparison of hemodynamic parameters in two groups2.1The HR(/min)、SBP(mmHg)、CO(L·min-1)、SVR(D.S×cm-5) SVRI(D.S×cm-5×m-2) of patients with CABG12hours prior to surgery in two groups were increased significantly; SV(mL/B)、SI[mL/(B·m2)]、ACI(/100s2)with admission decreased, but there was significant difference between two groups (P<0.05).2.2In two groups24hours after CABG, HR(/min)、SBP(mmHg)、MAP(mmHg)、 CO(L·min-1)、SVR(D.S×cm-5)、SVRI(D.S×cm-5×m-2) were significantly decreased than that of before CABG, but the difference had no statistical significance between two groups (P>0.05);2.3patients in the intervention group72hours after CABG CO(L· min-1)significantly increased, HR (/min), SBP (mmHg), MAP (mmHg), SVR(D.S×cm-5)、SVRI(D.S×cm-5×m-2) decreased significantly than that before operation, and there was significant difference between two groups (P<0.05).3. Comparison of chest tube drainage, tracheal intubation indwelling time, ICU monitoring time and hospital days in two groups.Postoperative intubation time, ICU monitoring time, the average hospital stay was significantly less than the control group, there was significant difference in two groups (P<0.05), thoracic drainage tube indwelling time of two groups had no significant difference (P>0.05).ConclusionsCognitive behavioral intervention can improve preoperative psychological status in patients with CABG, effectively reduce the surgical patients caused by stress and reflective heart rate, blood pressure, reduce anxiety and depression scores, meanwhile it can stabilize the hemodynamic, increase cardiac output, promote the postoperative recovery, improve the quality of life of patients, is worthy of clinical application. |
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