四阶段式早期康复训练对急性心肌梗死经股动脉PCI术后老年患者的影响  

The Effect of Four-Stage Early Rehabilitation Program on Elderly Patients with Acute Myocardial Infarction after transfemoral PCI

作　　者：王红[1] 马秀丽 李迎新 程青 张茜茜[1] Wang Hong;Ma Xiuli;Li Yingxin;Cheng Qing;Zhang Qianqian(Beijing Chaoyang Hospital Affiliated to Capital Medical University,Beijing 100020,China;不详)

机构地区：[1]首都医科大学附属北京朝阳医院冠心病重症监护室,北京市100020

出　　处：《中国病案》2022年第6期103-107,共5页Chinese Medical Record

摘　　要：目的 应用四阶段式早期下地康复训练在急性心肌梗死经股动脉PCI术后老年患者,以期达到提高患者心脏功能,为临床护理提供循证依据。方法 选择2018年1月5日-2020年5月23日在北京市某三甲医院冠心病重症监护室住院的急性心肌梗死经股动脉穿刺的PCI术后老年患者随机分为实验组60例,对照组60例。实验组根据制定的四阶段式早期康复活动方案进行下地康复训练,对照组采用CCU常规康复护理措施,比较实验组和对照组患者的首次离床时间、脑利纳肽水平、左室射血分数、日常生活自理能力、CCU住院时间的差异。结果 实验组首次离床时间(30.25±0.68)小时低于对照组(48.78±0.96)小时,差异具有统计学意义(t=-0.537,P<0.001);实验组脑利钠肽水平(690.88±134.58)pg/ml低于对照组(745.29±146.74)pg/ml,差异具有统计学意义(t=-3.825,P=0.003);实验组左室射血分数(63.78±6.45)%优于对照组(55.43±9.64)%,差异具有统计学意义(t=4.725,P=0.023);实验组日常生活自理能力评分(62.37±7.51)分高于对照组(59.47±7.82)分,差异具有统计学意义(t=3.327,P=0.002);实验组住院时间(4.03±1.48)天短于对照组(7.15±2.67)天,差异具有统计学意义(t=-2.786,P<0.001)。结论 四阶段式早期下地康复训练对急性心肌梗死经股动脉PCI术后老年患者康复训练安全有效,可明显提高患者心脏功能,改善患者预后,缩短CCU住院时间。Objectives To investigate the effect of four-stage early rehabilitation program on the elderly patients with acute myocardial infarction after transfemoral PCI.Methods A total of 120 elderly patients with acute myocardial infarction after transfemoral PCI who admitted to CCU from January 2018 to May 2020 were randomly divided into experimental group and control group,60 cases in each group.The control group received the regular rehabilitation plan,while the experimental group was provided with the four-stage early rehabilitation program.The differences between the experimental group and the control group in the time to get out bed for the first time,the brain natriuretic peptide(BNP),left ventricular ejection fractions(LVEF),activity of daily living(ADL),and CCU hospitalization time were compared.Results The time to get out bed for the first time in the experimental group was(30.25±0.68) h,which was lower than that in the control group(48.78±0.96) h(t=-0.537,P<0.001);The BNP level in the experimental group was(690.88±134.58) pg/ml,which was lower than the control group(745.29±146.74) pg/ml(t=-3.825,P=0.003);The LVEF of the experimental group was(63.78±6.45)%,which was better than the control group(55.43±9.64)%(t=4.725,P=0.023);The score of ADL of the experimental group was(62.37±7.51),which was higher than that of the control group(59.47±7.82)(t=3.327,P=0.002);The CCU hospitalization time of the experimental group was(4.03±1.48) days,which was shorter than the control group(7.15±2.67)(t=-2.786,P<0.001),and the differences were statistically significant(all P<0.05).Conclusions This study showed that the four-stage early rehabilitation program was safe and effective for elderly patients with acute myocardial infarction after transfemoral PCI.It could significantly improve the cardiac function of the patients,and shorten hospitalization time.

关 键 词：心肌梗死 经皮冠状动脉介入 早期康复 护理 

分 类 号：R542.22[医药卫生—心血管疾病] R493[医药卫生—内科学]