张蔚　雷雪贞　梁艳

[摘要] 目的 探讨系统化失眠护理干预对冠心病合并高血压失眠患者睡眠质量以及临床并发症的改善效果。 方法 将2015年12月～2016年12月我院收治的100例冠心病合并高血压失眠患者作为研究对象，随机分为观察组和对照组各50例。对照组实施常规护理干预，观察组给予系统化失眠护理干预。采用PSQI量表评估两组患者的睡眠质量情况，并记录临床并发症的发生情况。 结果 干预后观察组睡眠质量总分、睡眠时间、睡眠潜伏期、睡眠效率、主观睡眠质量、日间功能障碍得分低于对照组，差异有高度统计学意义（P<0.01），两组患者干预后睡眠质量总分及各维度得分均低于干预前得分，差异有高度统计学意义（P<0.01）。观察组住院期间心律失常、心力衰竭、再发心绞痛、心肌再梗死的发生率低于对照组，差异有统计学意义（P<0.05）。 结论 实施系统化失眠护理干预能够改善冠心病合并高血压失眠患者的睡眠质量，降低临床并发症的发生率。

[关键词] 系统化失眠护理；冠心病合并高血压；睡眠质量；改善效果

[中图分类号] R473.5 [文献标识码] B [文章编号] 1673-9701（2017）16-0145-04

[Abstract] Objective To explore the improvement effect of systematic insomnia nursing intervention on the sleep quality and clinical complications in the patients with coronary heart disease complicated with hypertension and insomnia. Methods 100 patients with coronary heart disease complicated with hypertension and insomnia who were admitted to our hospital from December 2015 to December 2016 were selected as the research subjects. They were randomly divided into the observation group and the control group， with 50 cases in each group. The control group was given routine nursing intervention， and the observation group was given systematic insomnia nursing intervention. PSQI scale was used to assess the sleep quality of both groups， and the occurrence of clinical complications was recorded. Results The overall score of sleep quality， sleep time， sleep latency， sleep efficiency， subjective sleep quality and daytime dysfunction score in the observation group after the intervention were significantly lower than those in the control group， and the differences were statistically significant（P<0.01）. The overall score of sleep quality and the scores of each dimension after the intervention in both groups were lower than those before the intervention， and the differences were statistically significant（P<0.01）. The incidence rate of arrhythmia， heart failure， recurrent angina pectoris and recurrent myocardial infarction was lower in the observation group than in the control group during hospitalization， and the differences were statistically significant（P<0.05）. Conclusion The implementation of systematic insomnia nursing intervention can improve the sleep quality in the patients with coronary heart disease complicated with hypertension and insomnia， and reduce the incidence rate of clinical complications.

[Key words] Systematic insomnia nursing； Coronary heart disease complicated with hypertension； Sleep quality； Improvement effect

冠狀动脉粥样硬化性心脏病，简称冠心病，指冠状动脉粥样性硬化导致血管狭窄、阻塞，引起心肌缺血、缺氧，甚至坏死的一类心脏疾病。高血压患者比常人患冠心病的概率高3～4倍，约60%～70%的冠心病患者有临床高血压症状出现，即冠心病伴高血压较常见[1]。失眠是由于心神失养或不安而导致的以经常不能获得正常睡眠为特征的一种临床表现，是高血压病患者的常见主诉[2]。研究显示，高血压患者合并失眠以入睡困难表现者居多，普遍表现为睡眠深度差、睡眠持续时间短[3]。对冠心病患者而言，原发疾病以及患者的周围环境都会对其睡眠质量造成一定影响[4]。因此，为改善冠心病合并高血压患者的失眠症状，本研究对该人群进行系统化失眠护理干预，取得了较好的效果，现报道如下。……