RESUMO
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 β 2 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 3 rd day after the operation, serum creatinine, serum urea nitrogen, urine β 2 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 β 2 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.