Intervention effect of clinical nursing pathway on the contrast induced nephropathy in percutaneous coronary intervention patients

Abstract

Objective To investigate the effect of clinical nursing pathway in prevention of contrast induced nephropathy in percutaneous coronary intervention patients. Methods A total of 118 cases of coronary heart disease patients who had undergo percutaneous coronary intervention in hospital from May 2018 to May 2019 were randomly divided into the intervention group (n=59) and the control group (n=59). Participants in the control group received routine nursing, while the intervention group carried out clinical nursing pathway nursing method. The renal index such as serum creatinine, blood urea nitrogen, urine β2 microglobulin, N-acetyl-beta-D-glucosidase (NAG) were compared before and after intervention between two groups, the incidence of CIN were also compared. Meanwhile, the psychology status and sleep quality was assessed by self-rating anxiety scale (SAS), self-rating depression scale (SDS) and Pittsburgh sleep quality index (PSQI), respectively. Results The 3rd day after the operation, serum creatinine, serum urea nitrogen, urine β2 microglobulin, NAG in the intervention group and control group were (81.06±15.60) μmol/L, (9.43 ± 2.73) mmol/L, (256.87 ± 18.99) μg/L, (19.56 ± 2.44) U/L and (87.87 ± 19.60) μmol/L, (10.55 ± 2.18) mmol/L, (270.45 ± 40.85) μg/L, (20.60 ± 2.13) U/L, respectively. The levels of serum creatinine, serum urea nitrogen, urine β2 microglobulin, NAG were significantly increased in the intervention group compared to the control group (t=2.087-2.464, P<0.05). The incidence of CIN in the intervention group were 3.4% (2/59) and 13.6% (8/59) in the control group, the differences had statistical significance (χ2=3.933, P<0.05). In addition, the scores of SAS, SDS and sleep quality, sleep time, sleep duration, daytime function and total PSQI score were (44.71 ± 8.20), (41.36 ± 6.52), (0.78 ± 0.11), (1.02 ± 0.15), (1.20 ± 0.19), (0.97 ± 0.27), (6.42 ± 0.54), those index were (48.85 ± 6.52), (46.49 ± 8.29), (1.03 ± 0.21), (1.23 ± 0.28), (1.44 ± 0.30), (1.30 ± 0.28), (7.79 ± 0.69), the differences had statistical significance (t=3.033-12.016, P<0.05). Conclusion Clinical nursing pathway can improve renal function, reduce the incidence of contrast-induced nephropathy, and improve psychological status and sleep quality of percutaneous coronary intervention patients. Key words: Clinical nursing pathway; Interventional cardiovascular therapy; Contrast induced nephropathy; Renal function