急性心肌梗死患者行经皮冠状动脉介入术后早期心脏康复护理效果研究  

Clinical effects of early cardiac rehabilitation nursing after percutaneous coronary intervention in patients with acute myocardial infarction

作　　者：齐建华 迟锦玉[1] QI Jianhua;CHI Jinyu(Department of Cardiology,The First Affiliated Hospital of Harbin Medical University,Heilongjiang,Harbin 150000,China)

机构地区：[1]哈尔滨医科大学附属第一医院心内科

出　　处：《河北医药》2019年第17期2713-2716,共4页Hebei Medical Journal

基　　金：哈尔滨医科大学创新科学研究资助项目(编号:2016LCZX42)

摘　　要：目的探讨早期心脏康复治疗在急性心肌梗死(AMI)患者行经皮冠状动脉介入术(PCI)后中的应用价值。方法96例AMI患者均行桡动脉PCI术,随机分为观察组和对照组,每组48例,对照组给予常规护理,观察组在对照组基础上给予早期心脏康复护理。于干预前、干预后14 d,检测2组患者心输出量(CO)、平均动脉压(MAP)、心率(HR)及左心室射血分数(LVEF)水平变化,行6 min步行试验(6MWT)评估患者运动耐量;干预后6个月,采用生活质量简表评估患者生活能力,并记录心脏不良事件发生情况。结果2组干预前CO、MAP、HR比较差异均无统计学意义(P>0.05);观察组干预后CO高于对照组,MAP低于对照组(P<0.05);2组干预前LVEF、6MWT比较差异均无统计学意义(P>0.05),干预后14 d LVEF较干预前增高,6MWT较干预前延长(P<0.05),且观察组较对照组变化明显(P<0.05);干预后6个月,观察组生活质量简表评分高于对照组(P<0.05),心律失常、心绞痛发生率均低于对照组(P<0.05),冠状动脉再狭窄、心力衰竭与对照组比较差异均无统计学意义(P>0.05)。结论早期心脏康复护理可改善行PCI术的AMI患者心功能,增加运动耐量,提高远期生活能力,降低心脏不良事件发生。Objective To investigate the application value of early cardiac rehabilitation in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods Ninety-six patients with AMI who underwent radial artery PCI in our hospital were randomly divided into observation group(n=48)and control group(n=48).The patients in control group were treated by routine nursing,however,the patients in observation group,on the basis of control group,were treated by early cardiac rehabilitation.The changes of cardiac output(CO),mean artery pressure(MAP),heart rate(HR),and left ventricular ejection fraction(LVEF)were measured before intervention and at 14 days after intervention.The exercise tolerance was evaluated by 6-minute walk test(6MWT)at 6 months after the intervention,moreover,the life quality was assessed by using life quality rating scale and cardiac adverse events were recorded.Results Before the intervention there were no significant differences in CO,MAP and HR between the two groups(P>0.05).After the intervention,the CO in observation group was significantly higher than that in control group,and the MAP was significantly lower than that in control group(P<0.05).Before the intervention there were no significant differences in LVEF and 6MWT between the two groups(P>0.05).At 14 days after the intervention,the LVEF was increased,and 6MWT was lengthened in both groups,moreover,the chnages in observation group were more significant than those in control group(P<0.05).After 6-month intervention,the life quality scores in observation group were significantly higher than those in control group(P<0.05),and the incidence rates of arrhythmia and angina were significantly lower than those in control group(P<0.05).There were no significant differences in the incidence rates of coronary artery restenosis and heart failure between the two groups(P>0.05).Conclusion The early cardiac rehabilitation can improve the cardiac function,increase exercise tolerance,improve long-term living ability and reduce the

关 键 词：急性心肌梗死 经皮冠状动脉介入术 早期心脏康复护理 左心室射血分数 生活能 

分 类 号：R542.22[医药卫生—心血管疾病]