心房颤动射频消融术后最佳下床活动时机对患者安全性和舒适度的影响  

Effects of optimum time of ambulation on comfort and safety of atrial fibrillation patients after radiofrequency ablation

作　　者：庄毅 朱傲霜[1] 毛一鸣 柴丽郁 王静怡 王淑洁 谢晶晶 李本玲[2] 邹芸 郑梅 纪元[1] 张良锋 孙铃[2] 郭佳 罗洁[2] 许亚静 Zhuang Yi;Zhu Aoshuang;Mao Yiming;Chai Liyu;Wang Jingyi;Wang Shujie;Xie Jingjing;Li Benling;Zou Yun;Zheng Mei;Ji Yuan;Zhang Liangfeng;Sun Ling;Guo Jia;Luo Jie;Xu Yajing(Department of Cardiovascular Medicine,Changzhou Second People's Hospital Affiliated to Nanjing Medical University,Yanghu Branch,Changzhou 213000,China;Department of Cardiovascular Medicine,Changzhou Second People's Hospital Affiliated to Nanjing Medical University,City Branch,Changzhou 213000,China)

机构地区：[1]南京医科大学附属常州市第二人民医院阳湖院区心血管内科,常州213000 [2]南京医科大学附属常州市第二人民医院城中院区心血管内科,常州213000

出　　处：《中国实用护理杂志》2022年第32期2481-2486,共6页Chinese Journal of Practical Nursing

摘　　要：目的探讨心房颤动射频消融术后最佳下床活动时机,为患者术后早期康复提供依据。方法采用便利抽样法,选取2020年1月至2021年5月南京医科大学附属常州市第二人民医院阳湖院区和城中院区经股静脉行射频消融术的120例心房颤动患者作为研究对象,按照随机数字表法分为早期组、中期组和后期组,每组40例。3组患者均给予常规术后干预,早期组首次下床活动时间为术后4 h,中期组为术后6 h,后期组为术后12 h。比较3组患者术后24 h内并发症发生率,并采用舒适状况量表(GCQ)评价3组患者术后24、48、72 h的舒适度。结果最终纳入患者111例,早期组37例,中期组38例,后期组36例。3组患者术后24 h内出血或血肿、尿潴留、腰痛发生率比较差异无统计学意义(P>0.05);早期组术后24 h内体位性低血压发生率为2.7%(1/37),低于中期组和后期组的21.1%(7/38)、25.0%(9/36),差异有统计学意义(χ^(2)=4.86、7.67,均P<0.05)。术后48、72 h,早期组生理维度得分、心理精神维度得分、GCQ总分分别为(20.68±3.07)、(22.54±3.35)、(81.68±6.11)分和(22.54±3.73)、(24.38±2.49)、(84.92±6.37)分,高于中期组的(19.16±2.19)、(21.32±2.27)、(78.24±5.58)分和(20.93±2.85)、(22.32±2.04)、(81.66±6.56)分,以及后期组的(18.44±1.50)、(21.31±1.99)、(78.06±4.32)分和(20.89±2.25)、(21.58±1.86)、(80.28±6.44)分,差异有统计学意义(t值为2.19~4.15,均P<0.05)。结论术后4 h下床活动不增加心房颤动射频消融术患者外周血管并发症,但可降低体位性低血压发生率和提高患者舒适度。Objective To explore the optimum time of ambulation of atrial fibrillation patients after radiofrequency ablation,to provide basis for patients'early postoperative rehabilitation.Methods By convenient sampling method,a total of 120 patients with atrial fibrillation after radiofrequency ablation were collected at Yanghu Branch and City Branch of Changzhou Second People's Hospital from January 2020 to May 2021.They were divided into the early group,middle group and late group according to the random number table method,each group were 40 cases.All patients received routine postoperative intervention,the time of ambulation were 4,6 and 12 h after operation in the early group,middle group and late group,respectively.The complication rate within 24 h after operation was compared among the three groups,and the comfort level of the three groups at 24,48 and 72 h after operation was evaluated with Comfort Status Scale(GCQ).Results Finally,111 patients were included,including 37 in the early group,38 in the middle group and 36 in the late group.There was no significant difference in the incidence of bleeding or hematoma,urinary retention,lumbago within 24 h after operation among the three groups(P>0.05).The incidence of postural hypotension within 24 h after operation in the early group was 2.7%(1/37),which was lower than 21.1%(7/38)and 25.0%(9/36)in the middle and late groups,with a statistically significant difference(χ^(2)=4.86,7.67,both P<0.05).At 48 and 72 h after operation,the scores of physiological dimension,psychological dimension and the total score of GCQ in the early group were(20.68±3.07),(22.54±3.35),(81.68±6.11)and(22.54±3.73),(24.38±2.49),(84.92±6.37),higher than those in the middle group(19.16±2.19),(21.32±2.27),(78.24±5.58),(20.93±2.85),(22.32±2.04),(81.66±6.56),and those in the late group(18.44±1.50)(21.31±1.99),(78.06±4.32),(20.89±2.25),(21.58±1.86),(80.28±6.44),the differences were statistically significant(t values were 2.19-4.15,all P<0.05).Conclusions Ambulation at 4 h after oper

关 键 词：心房颤动 射频消融 早期下床活动 并发症 舒适度 

分 类 号：R473.5[医药卫生—护理学]