早期康复运动训练在急性心肌梗死患者血栓抽吸术后的护理研究  

Effect observation of early rehabilitation exercise training after thrombus aspiration in patients with acute myocardial infarction

作　　者：周秀红[1] 杜新平[1] 李文杰[1] 胡圣[1] 薛金红[1] 苑丹丹 杜姣姣[1] Zhou Xiuhong;Du Xinping;Li Wen jie;Hu Sheng;Xue Jin hong;Yuan Dandan;Du Jiaojiao(The Fifth Central Hospital of Tianjin City, Tianjin 30045)

机构地区：[1]天津市第五中心医院,天津300450

出　　处：《护士进修杂志》2018年第10期867-870,879,共5页Journal of Nurses Training

基　　金：天津市滨海新区塘沽科技兴区项目(编号:2005XQ11-07)

摘　　要：目的探讨急性心肌梗死患者行血栓抽吸术后早期进行康复运动训练的护理效果。方法选取我院2014年1月-2016年12月因急性心肌梗死行血栓抽吸术后的患者84例,按随机数字表法分为观察组和对照组各42例。两组患者在血栓抽吸治疗术后均接受常规护理,观察组同时予以早期康复运动训练。观察两组患者住院期间血流动力学变化,患者舒适度情况、血管并发症、主要心血管不良事件(MACE)、出血并发症的发生率及术后1周及3个月后射血分数(EF)、左室短轴缩短率(FS)、左室舒张末径(LVEDd)、左室收缩末径(LVRDs)及6min步行试验(6MWT)的变化。结果两组患者的血流动力学指标比较,观察组心输出量、舒适度较对照组明显提高,差异有统计学意义(P<0.05);观察组收缩压、舒张压、平均动脉压较康复训练前明显降低;观察组患者在住院期间总的MACE发生率为4.8%,低于对照组。观察组患者运动后1周及3个月的EF、FS较对照组高,6MWT较运动前升高。而LVEDd及LVRDs较对照组患者低,两组比较差异有统计学意义(P<0.05)。结论急性心肌梗死患者行血栓抽吸术后早期进行康复运动训练,可以增加患者冠状动脉血液流动性,提高心输出量,有效降低血压,增加患者的舒适度,减少新发病变。Objective To study the effect of nursing care for patients with acute myocardial infarction after thrombus aspiration early rehabilitation training.Methods 84 patients were selected and divided into experimental group and control group using prospective randomized,for acute myocardial infarction patients after thrombus aspiration,The two groups received routine care after the thrombus aspiration treatment,while the experimental group received early rehabilitation exercise（gradual,individualized,low intensity exercise program）.The major adverse cardiovascular events（MACE）,incidence of bleeding complications,hemodynamic changes,comfort,change in patients with vascular complications and major adverse after 1 weeks and 3 months after the ejection fraction（EF）,left ventricular fractional shortening（FS）,left ventricular end-diastolic dimension（LVEDd）,left ventricular end systolic diameter（LVRDs）and six minutes walk test（6 MWT）changes was observed and compared between two groups.Results Compared the hemodynamic indexes between the two groups,the cardiac output and comfort of the experimental group were significantly higher than that of the control group.There was significant difference between the two group（P0.05）.At the same time,the systolic pressure,diastolic pressure and mean arterial pressure of the experimental group were significantly lower than those before the rehabilitation training（P0.05）.The total incidence of MACE in the experimental group during the hospitalization period was（4.8%）lower than that in the control group（23.8%）.The EF and FS of the experimental group after 1 and 3 months of exercise were not higher than that of the control group,and 6 MWT was higher than that before the exercise.The LVEDd and LVRDs were lower than those in the control group,There was significant difference between the two group（P0.05）.Conclusion Acute myocardial infarction underwent thrombus aspiration after early rehabilitation exercise training can increase coronary blood flow,

关 键 词：心肌梗死 血栓抽吸术 康复运动训练 护理 

分 类 号：R493[医药卫生—康复医学]