早期心脏康复联合渐进式护理在急性心肌梗死PCI术后ICU护理中的应用效果研究

Application effect of early cardiac rehabilitation combined with progressive nursing in intensive care unit nursing after percutaneous coronary intervention for acute myocardial infarction

目的探讨早期心脏康复联合渐进式护理在急性心肌梗死PCI术后ICU护理中的应用效果。方法选取我院于2022年5月至2023年5月期间收诊的急性心梗PCI术治疗的120例患者,按照随机数表法分为对照组和观察组,每组60例。给予对照组患者常规护理,给予观察组患者在对照组基础上加入早期心脏康复联合渐进式护理,比较心脏功能指标、不良心血管事件发生次数、心功能分级、应对方式问卷(CSQ)评分、心理应激反应(SCL-90)评分、护理满意度。结果护理后,观察组的LVEF、LVEDD较对照组更高(P<0.05)。观察组出现猝死、再发急性心肌梗死、心绞痛、严重心律失常、心力衰竭等不良心血管事件发生率高于对照组,但差异无统计学意义(P>0.05)。观察组Ⅰ级、Ⅱ级人数多于对照组,Ⅲ级、Ⅳ级人数少于对照组(P<0.05)。观察组的CSQ评分显著高于对照组,SCL-90评分低于对照组(P<0.05)。观察组的护理满意度高于对照组(P<0.05)。结论早期心脏康复联合渐进式护理可有效提高PCI术后急性心肌梗死患者的心脏功能,优化心功能分级,改善患者的心理状态和提高护理满意度。尽管对不良心血管事件的影响未见统计学差异,但该综合护理模式有助于提高患者的整体康复质量。

Objective To investigate the application effect of early cardiac rehabilitation combined with progressive nursing in intensive care unit(ICU)nursing after percutaneous coronary intervention(PCI)for acute myocardial infarction.Methods A total of 120 patients who were admitted to our hospital and underwent PCI for acute myocardial infarction from May 2022 to May 2023 were enrolled and divided into control group and observation group using a random number table,with 60 patients in each group.The patients in the control group were given routine nursing,and those in the observation group were given early cardiac rehabilitation combined with progressive nursing in addition to the nursing in the control group.The two groups were compared in terms of cardiac function parameters,number of adverse cardiovascular events,cardiac functional grading,coping style questionnaire(CSQ)score,mental stress reaction(SCL-90)score,and degree of satisfaction with nursing.Results After nursing,the observation group had significantly higher left ventricular ejection fraction and left ventricular end-diastolic diameter(P<0.05).Compared with the control group,the observation group had higher incidence rates of the adverse cardiovascular events such as sudden death,recurrent acute myocardial infarction,angina pectoris,severe arrhythmia,and heart failure(P>0.05).Compared with the control group,the observation group had significantly higher numbers of patients with grade I/II cardiac function and significantly lower numbers of patients with grade III/IV cardiac function(P<0.05).Compared with the control group,the observation group had a significantly higher CSQ score and a significantly lower SCL-90 score(P<0.05).The observation group had a significantly higher degree of satisfaction with nursing than the control group(P<0.05).Conclusion For patients withacute myocardial infarctionafter PCI,early cardiac rehabilitation combined with progressive nursing can effectively improve cardiac function,optimize cardiac functional grading,improve psychological state,and increase the degree of satisfaction with nursing.Although no statistical difference is observed for adverse cardiovascular events,such comprehensive nursing pattern can help to improve the overall rehabilitation quality of patients.