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

摘要： 背景　急诊经皮冠状动脉介入术（PCI）后存在诸多并发症，尤其是术后心脏康复早期，医护人员应对该阶段患者进行跟踪。生活空间能反映术后心脏康复情况，但目前PCI后生活空间的研究较少。目的　分析急诊PCI前后患者生活空间变化及术后生活空间的影响因素。方法　采用便利抽样法，选取2018年1月—2019年1月在上海交通大学医学院附属瑞金医院行急诊PCI的119名患者为研究对象。采用一般资料及疾病信息采集表、中国老年人生活空间评价量表（LSA-C）、冠心病自我管理行为量表（CSMS）对其进行调查，并于患者出院后6个月进行电话随访。采用Pearson相关性分析探讨CSMS得分与LSA-C得分的相关性，采用多元线性回归分析探讨急诊PCI后患者LSA-C总分的影响因素。结果　不同文化程度、常住地、既往病史（高血压、高脂血症、糖尿病）、是否首次PCI情况的PCI后患者LSA-C总分比较，差异均有统计学意义（P<0.05）。急诊PCI后卧室外活动、小区内活动、小区附近街道或村镇活动得分及LSA-C总分高于PCI前，本市其他街道或村镇活动得分低于PCI前（P<0.05）。日常生活管理、疾病医学管理、情绪管理得分及CSMS总分与室外公寓大楼内活动、小区内活动、本市其他街道或村镇活动得分及LSA-C总分均呈正相关（P<0.05）。多元线性回归分析结果显示，CSMS总分（β=1.287）、既往高血压（β=-4.515）是急诊PCI后患者LSA-C总分的影响因素（P<0.05）。结论　急诊PCI后生活空间得分高于PCI前，主要为中小范围活动得分有所提升，大范围活动仍受限。自我管理能力低、既往有高血压是急诊PCI后老年患者生活空间恢复的危险因素。

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