全路径护理在心脏瓣膜置换术后患者心脏功能和术后恢复的效果研究

Effect of whole-pathway nursing on cardiac function and postoperative recovery after heart valve replacement

目的探究全路径护理对于心脏瓣膜置换术患者的心脏功能和术后恢复的效果。方法选择南通大学附属医院2020年6月至2022年9月接受心脏瓣膜置换术的120例患者,采用随机数表法分为对照组60例和观察组60例,对照组接受常规护理,观察组接受全路径护理,收集两组心脏功能、术后恢复情况、心理健康和生活质量等资料。结果护理后,观察组左心室射血分数(LVEF)、左室短轴缩短率(LVFS)高于对照组(P<0.05)。观察组ICU停留,首次排气、排便、下床活动时间及住院时间均短于对照组(P<0.05)。护理后,观察组症状自评量表-90(SCL-90)抑郁、焦虑、敌对、人际关系敏感、恐怖、强迫、偏执、精神病性、躯体化因子分值低于对照组(P<0.05),生活质量综合评定问卷-74(GQOLI-74)社会功能、躯体功能、心理功能、物质生活状态维度分值高于对照组(P<0.05)。结论全路径护理有利于提升心脏瓣膜置换术患者心脏功能,促进术后恢复,改善心理健康和生活质量。

Objective:To investigate the effect of whole-pathway nursing combined with electrocardiogram monitoring on cardiac function and recovery of patients after heart valve replacement.Methods:A total of 120 patients who underwent heart valve replacement at Affiliated Hospital of Nantong University from June 2020 to September 2022 were selected.They were divided into control group(60 cases)and observation group(60 cases)using the random number table method.The control group received routine nursing and electrocardiogram monitoring,while the observation group received whole-pathway nursing combined with electrocardiogram monitoring.The two groups were compared on cardiac function,postoperative recovery,mental health,and quality of life.Results:After nursing,left ventricular ejection fraction(LVEF),left ventricular fractional shortening(LVFS)of observation group were higher than control group(P<0.05).The length of ICU stay,first exhaust time,first defecation time,first ambulation time,and length of hospital stay in observation group were shorter than control group(P<0.05).After nursing,the scores of depression,anxiety,hostility,interpersonal sensitivity,fear,obsession,paranoia,psychosis and somatization factors of Symptom Checklist-90(SCL-90)in the observation group were lower than those in the control group(P<0.05)and the scores of social function,physical function,psychological function and material life status of GQOLI-74 were higher than those of control group(P<0.05).Conclusion:Whole-pathway nursing is conducive to improving cardiac function,promoting postoperative recovery,and improving mental health and quality of life of patients undergoing heart valve replacement.