早期个体化心脏康复护理对急诊经皮冠状动脉介入术后心肌梗死患者临床疗效的影响  

Influence of application of early individualized cardiac rehabilitation nursing on clinical therapeutic effect of patients with myocardial infarction after emergency percutaneous coronary intervention

作　　者：杨阳[1] Yang Yang(Cardiac Department Catheterization Room,Tianjin First Central Hospital,Tianjin 300192,China)

机构地区：[1]天津市第一中心医院心内科导管室,天津300192

出　　处：《中国中西医结合急救杂志》2021年第1期95-98,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

摘　　要：目的观察早期个体化心脏康复护理对急诊经皮冠状动脉介入治疗(PCI)术后心肌梗死(心梗)患者疗效的影响.方法选择天津市第一中心医院2017年8月至2019年8月收治的106例行PCI的急性心梗患者作为研究对象.将患者按护理方案不同分为常规护理组和个体化护理组,每组53例.常规护理组于PCI后密切监测患者病情变化并给予药物治疗、生活和运动指导等.个体化护理组制定个体化心脏康复护理方案,术后1~2 d以低强度康复训练为主;术后3~4 d鼓励患者床边静坐,在耐受的情况下协助和引导患者床边站立;术后5~9 d鼓励患者开始独立缓慢行走;术后8~10 d实现生活自理;术后10~15 d出院后可自行康复训练;术后16~30 d开展慢跑及上下楼训练,均每次10 min、每日3次.观察两组患者干预前后心排血量、平均动脉压(MAP)、心率、左室射血分数(LVEF)、6 min步行距离、生活质量评分的变化以及两组不良反应发生率、心脏重症监护病房(CCU)住院时间、首次排便时间、总住院时间.结果两组干预后心排血量、LVEF、6 min步行距离、生活质量评分均较干预前升高,MAP较干预前降低;且个体化护理组较常规护理组变化更显著〔心排血量(L/min):7.08±1.56比5.71±1.43,LVEF:0.56±0.04比0.52±0.04,6 min步行距离(m):357.39±16.15比326.43±15.50,生活质量总评分(分):81.72±6.86比65.86±6.18,心理评分(分):22.64±3.34比18.32±2.72,生理评分(分):23.74±3.27比20.01±3.05,环境评分(分):22.56±3.12比18.72±2.87,独立性评分(分):14.01±2.08比8.32±1.62,MAP(mmHg,1 mmHg≈0.133 kPa):82.35±6.95比87.57±6.24,均P<0.05〕.个体化护理组不良事件发生率明显低于常规护理组〔9.43%(5/53)比41.51%(22/53)〕,CCU住院时间、首次排便时间和总住院时间均较常规护理组明显缩短〔CCU住院时间(h):41.31±4.52比48.46±4.83,首次排便时间(h):42.57±4.50比50.46±5.72,总住院时间(d):9.07±1.54比11.64±2.73,均P<0.05�Objective To observe the early application of individualized cardiac rehabilitation nursing on therapeutic effect of patients with acute myocardial infarction after emergency percutaneous coronary intervention(PCI).Methods The 106 patients with myocardial infarction who underwent PCI in Tianjin First Central Hospital from August 2017 to August 2019 were selected as the research objects.The patients were divided into a routine nursing group and an individualized nursing group according to difference in nursing plans,with 53 cases in each group.After PCI,in the routine nursing group,the changes of patients'disease situations were closely monitored,and drug treatment,guidance on life and exercise were carried out;in the individualized nursing group,various individualized cardiac rehabilitation nursing plans were developed.The low intensity rehabilitation training should be used primarily for patients 1-2 days after operation;on 3-4 days after operation,the patients should be encouraged to sit at the bedside,and under the patients'tolerance,the nurse could lead and help the patients stand at bedside;on 5-9 days after operation,the patients were encouraged to carry out independent slow walking;on 8-10 days after operation,the patients could achieve taking care of themselves in living;after 10-15 days of operation,the patients could be discharged,and then they could be self-regulating their training process;on 16-30 days after surgery,jogging and going upstairs and downstairs training were carried out,each time for 10 minutes,three times a day.The changes in cardiac output,mean arterial pressure(MAP),heart rate,left ventricular ejection fraction(LVEF),6-minute walking distance,quality of life score,incidence of adverse reactions,coronary care unit(CCU)stay time,first defecation time and total hospitalization time were observed in the two groups before and after intervention.Results After intervention,the levels of cardiac output,6-minute walking distance and quality of life score in two groups were higher than those be

关 键 词：早期个体化心脏康复 急诊经皮冠状动脉介入 心肌梗死 心脏功能 生活质量 

分 类 号：R47[医药卫生—护理学]