关键词: 冠心病, 日常生活活动, 心脏康复, 老年人, 急诊, 经皮冠状动脉介入术, 生活空间, 影响因素分析, 自我管理

Abstract: Background　Many complications may occur after emergency percutaneous coronary intervention（PCI），especially in postoperative early cardiac rehabilitation.So patients in post-PCI early cardiac rehabilitation should be closely followed up by medical workers life space can reflect postoperative cardiac rehabilitation，but there are few studies on this aspect.Objective　To perform a comparative analysis of pre- and post-emergency PCI life space，and to investigate the influencing factors of postoperative life-space.Methods　Using convenience sampling，a total of 119 patients who underwent emergency PCI in Ruijin Hospital，Shanghai Jiaotong University School of Medicine from January 2018 to January 2019 were enrolled.They received a questionnaire survey using a self-developed Demographic and Disease Information Questionnaire，Life-space Assessment Scale for the Elderly in China（LSA-C），and the Coronary Disease Self-Management Scale（CSMS）for investigating corresponding data，and a telephone-based survey at six months after discharge.Pearson correlation analysis was used to explore the correlation between CSMS score and LAS-C score.Multiple linear regression analysis was used to analyze the influencing factors of LAS-C total score after emergency PCI.Results　 The total score of LSA-C after emergency PCI varied significantly by education level，usual residence，history of hypertension，hyperlipidemia，and diabetes，and prevalence of initial PCI（P<0.05）.After emergency PCI，the scores of activities outside the bedroom，in the community，in the neighborhood streets or villages and towns and the total scores of LSA-C increased，while the scores of activities in other streets or villages and towns in this city decreased than the preoperative levels（P<0.05）.The scores of daily life management，medical management，emotion management and CSMS were positively correlated with the scores of outdoor activities，activities in the community，activities in the streets or villages in the city，and the total scores of LSA-C（P<0.05）.Multiple linear regression analysis showed that the total scores of CSMS（β=1.287）and history of hypertension（β=-4.515）were the influencing factors of the total score LSA-C（P<0.05）after emergency PCI.Conclusion　The life-space increased after emergency PCI.The scores of small and medium range activities increased than before，but those of large range activities were still limited.Low self-management level and previous hypertension were risk factors for the recovery of life-space in elderly patients after emergency PCI.

Key words: Coronary disease, Activities of daily living, Cardiac rehabilitation, Aged, Emergency, Percutaneous coronary intervention, Life-space, Root cause analysis , Self management