早期心脏康复路径在机械循环辅助支持暴发性心肌炎患者中的应用  

Application of Early Cardiac Rehabilitation Pathway in Patients with Fulminant Myocarditis Undergoing Mechanical circulatory assistance support

作　　者：马凌燕[1] 牛子妹 孙卓铖 吴少杰 杨海鸿[1] Ma Lingyan;Niu Zimei;Sun Zhuocheng(Henan Provincial People′s Hospital,Zhengzhou Henan 450000,China)

机构地区：[1]河南省人民医院、阜外华中医院、郑州大学阜外华中医院,河南郑州450000

出　　处：《齐鲁护理杂志》2023年第13期21-25,共5页Journal of Qilu Nursing

基　　金：河南省医学科技攻关计划联合共建立项项目(项目:LHGJ20200115)。

摘　　要：目的:探讨早期心脏康复路径在机械循环辅助支持暴发性心肌炎(FM)患者中的应用效果。方法:选取2019年9月1日~2022年6月1日收治的88例FM患者为研究对象,采用随机数字表法分为观察组和对照组各44例,对照组实施机械循环辅助支持和常规护理,观察组在对照组基础上实施早期心脏康复路径;比较两组干预前后实验室指标[包括肌钙蛋白值、乳酸值、肌酐值、血清白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、白细胞介素-7(IL-7)]、心率、血压、左心室射血分数及临床指标[包括体外膜肺氧合(ECMO)撤机时间、撤机成功率、治愈率]。结果:干预后,两组肌钙蛋白、乳酸、肌酐、血清IL-2、IL-6、IL-7水平均低于干预前(P<0.05),且观察组低于对照组(P<0.01);干预后,两组心率、血压、左心室射血分数均优于干预前(P<0.05),且观察组优于对照组(P<0.01)。结论:在机械循环辅助支持下,采用早期心脏康复路径可改善FM患者心血管功能,有助于患者心理、生理等方面恢复至较佳状态,降低感染率,从而改善预后。Objective:To explore the application effect of early cardiac rehabilitation pathway in patients with fulminant myocarditis undergoing mechanical circulatory assistance support.Methods:A total of 88 patients with fulminant myocarditis admitted from September 1,2019 to June 1,2022 were selected as the study subjects,and were divided into the observation group and the control group by the random number table method,with 44 cases in each group.The control group received mechanical circulatory assistance support,and the observation group was given early cardiac rehabilitation pathway combined with mechanical circulatory assistance support.Laboratory indexes such as troponin,lactic acid and creatinine,serum levels of interleukin-2(IL-2),interleukin-6(IL-6)and interleukin-7(IL-7),heart rate,blood pressure,left ventricular ejection fraction,and clinical indexes such as extracorporeal membrane oxygenation(ECMO),weaning time,weaning success rate,cure rate and adverse reactions were compared between the two groups of patients before and after intervention.Results:After intervention,the levels of troponin,lactic acid and creatinine,serum levels of IL-2,IL-6 and IL-7 in both groups were lower than those before intervention(P<0.05),and those in the observation group were lower than those in the control group(P<0.01).After intervention,the heart rate,blood pressure and left ventricular ejection fraction in both groups were higher than those before intervention(P<0.05),and those in the observation group were higher than those in the control group(P<0.01).Conclusion:Under mechanical circulatory assistance support,early cardiac rehabilitation pathway can significantly improve the cardiovascular function of patients with fulminant myocarditis,and help patients to recover to a better state in psychological and physiological aspects,reduce the infection rate and improve the prognosis.

关 键 词：早期心脏康复 机械循环辅助 暴发性心肌炎 感染率 

分 类 号：R473.54[医药卫生—护理学]