基于微信多媒体课堂的综合管理干预对老年急性心肌梗死患者心功能康复及预后的影响  

Effect of comprehensive management intervention based on WeChat multimedia classroom on cardiac function rehabilitation and prognosis in elderly patients with acute myocardial infarction

作　　者：王鸽 杨宁 杨敏 鲍花 刘楠 强改玲 赵海艳 WANG Ge;YANG Ning;YANG Min;BAO Hua;LIU Nan;QIANG Gai-ling;ZHAO Hai-yan(First Ward,Department of Geriatrics,the Second Affiliated Hospital of Chinese PLA Air Force Military Medical University,Xi'an,Shaanxi,710038,China)

机构地区：[1]中国人民解放军空军军医大学第二附属医院老年医学科一病区,陕西西安710038 [2]中国人民解放军空军军医大学第二附属医院康复科,陕西西安710038 [3]中国人民解放军空军军医大学第二附属医院病案室,陕西西安710038 [4]中国人民解放军空军军医大学第二附属医院健康管理科,陕西西安710038 [5]中国人民解放军空军军医大学第二附属医院心内科一病区,陕西西安710038

出　　处：《心血管康复医学杂志》2025年第1期51-56,共6页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探究基于微信多媒体课堂的综合管理干预对老年急性心肌梗死(AMI)患者的心功能及预后的影响。方法:回顾性收集2021年8月至2022年12月118例在中国人民解放军空军军医大学第二附属医院诊断为AMI的老年患者的临床资料,根据术后护理方式的不同分为干预组(n=58,基于微信多媒体课堂的综合管理干预)与对照组(n=60,综合管理干预),两组均进行5个月的干预。比较两组患者心功能、运动耐力、康复管理依从性、自我效能感及健康行为。采用Kaplan-Meier生存曲线比较两组患者在随访期间不良心血管事件发生情况。结果:干预5个月后,与对照组比较,干预组患者左室射血分数(LVEF)[(58.14±1.88)%比(54.48±1.34)%]、6min步行距离(6MWD)[(490.41±59.59)m比(394.97±28.20)m]、康复管理依从性[(6.97±2.03)分比(5.03±1.40)分]、一般自我效能感量表(GSES)[(30.34±4.67)分比(23.55±4.86)分]及健康促进生活方式量表(HPLP-II)[(137.62±30.17)分比(115.95±22.66)分]评分均显著增加,左心室舒张末期容积(LVEDV)[(117.90±4.22)ml比(131.28±3.61)ml]、左心室收缩末期容积(LVESV)[(54.46±2.10)ml比(63.15±2.06)ml]、血清脑钠肽(BNP)[(362.32±25.36)pg/ml比(567.58±21.90)pg/ml]水平及不良心血管事件发生率(6.90%比21.67%)显著降低(P<0.05或<0.01)。结论:基于微信多媒体课堂的综合管理干预可显著改善老年AMI患者的心功能、提高运动耐力、康复依从性、自我效能感、健康行为,降低术后不良心血管事件的发生率。Objective:To investigate effect of comprehensive management intervention based on WeChat multimedia classroom on cardiac function and prognosis in elderly patients with acute myocardial infarction(AMI).Methods:Clinical data of 118 elderly patients diagnosed with AMI in the Second Affiliated Hospital of Chinese PLA Air Force Military Medical University between August 2021 and December 2022 were retrospectively collected.According to nursing way after operation,they were divided into control group(n=60,comprehensive management intervention)and intervention group(n=58,comprehensive management intervention based on WeChat multimedia classroom),both groups were intervened for 5 months.Cardiac function,exercise tolerance,compliance to rehabilitation management,self-efficacy and healthy behavior were compared between two groups.Kaplan-Meier survival curve was employed to compare incidence of adverse cardiovascular events during follow-up between two groups.Results:After 5-month intervention,compared with patients in control group,those in intervention group had significant higher left ventricular ejection fraction(LVEF)[(58.14±1.88)%vs.(54.48±1.34)%],6min walking distance(6MWD)[(490.41±59.59)m vs.(394.97±28.20)m],scores of compliance to rehabilitation management[(6.97±2.03)points vs.(5.03±1.40)points],General Self-Efficacy Scale(GSES)[(30.34±4.67)points vs.(23.55±4.86)points]and Health Promoting Lifestyle Profile-II[(137.62±30.17)points vs.(115.95±22.66)points],and significant lower left ventricular end-diastolic volume(LVEDV)[(117.90±4.22)ml vs.(131.28±3.61)ml],left ventriadar end-systolic volume(LVESV)[(54.46±2.10)ml vs.(63.15±2.06)ml],serum brain natriuretic peptide(BNP)[(362.32±25.36)pg/ml vs.(567.58±21.90)pg/ml]and incidence of adverse cardiovascular events(6.90%vs.21.67%)(P<0.05 or<0.01).Conclusion:Comprehensive management intervention based on the WeChat multimedia classroom could significantly improve cardiac function,exercise tolerance,compliance to rehabilitation,self-efficacy and healthy behav

关 键 词：心肌梗死 护理 预后 

分 类 号：R542.22[医药卫生—心血管疾病]