急性心肌梗死经皮冠状动脉介入术患者跨理论模式联合心脏康复训练护理体会

Nursing experience of trans-theoretical model combined with cardiac rehabilitation training in patients with acute myocardial infarction undergoing percutaneous coronary intervention

目的急性心肌梗死病情急,进展快,经皮冠状动脉介入术(percutaneous coronary intervention,PCI)是临床治疗急性心肌梗死的重要方式,术后有效的预防措施能够有效降低复发率,促进疾病转归。本研究旨在探讨跨理论模式联合心脏康复对老年急性心肌梗死PCI术后患者心脏功能、运动耐力及知信行水平的影响。方法选择2018-06-01-2019-06-01于安阳市中医院行PCI手术治疗的115例老年急性心肌梗死患者,根据两组一般资料有可比性的原则分组。57例对照组实施跨理论模式进行健康教育,58例观察组在对照组基础上增加心脏康复治疗。对比两组治疗后心脏功能、知信行水平、抗氧化能力及运动耐力水平。结果治疗后,观察组最大摄氧量为(20.02±2.11)mL/(kg·min),高于对照组的(16.83±2.04)mL/(kg·min),t=8.240,P<0.001;运动持续时间为(402.15±16.29)s,高于对照组的(388.72±15.40)s,t=4.542,P<0.001。观察组超氧化物歧化酶为(91.47±4.11)U/mL,高于对照组的(86.93±4.04)U/mL,t=5.973,P<0.001;总抗氧化能力为(14.38±1.10)U/mL,高于对照组的(11.39±2.05)U/mL,t=9.770,P<0.001。观察组6min步行试验距离为(347.05±15.08)m,远于对照组的(322.85±14.94)m,t=8.644,P<0.001;左心室射血分数为(58.28±4.11)%,高于对照组的(55.86±4.34)%,t=3.071,P=0.001。观察组知信行健康知识评分为(109.37±8.25)分,高于对照组的(101.29±7.17)分,t=5.602,P<0.001;健康信念评分为(28.55±3.61)分,高于对照组的(23.57±3.69)分,t=7.316,P<0.001;健康行为评分为(33.59±4.07)分,高于对照组的(29.15±3.66)分,t=6.148,P<0.001。结论跨理论模式联合心脏康复可改善老年急性心肌梗死PCI术后患者的心脏功能和抗氧化能力,增强运动耐力,提高知信行水平。

OBJECTIVE Acute myocardial infarction is an acute disease with rapid progress.Percutaneous coronary intervention(PCI)is an important way to treat acute myocardial infarction clinically.Effective postoperative preventive measures can effectively reduce the recurrence rate and promote disease outcome.The purpose of this study was to investigate the effects of trans-theoretical models combined with cardiac rehabilitation on cardiac function,exercise endurance,and the level of knowledge,belief,and practice in elderly patients with acute myocardial infarction after PCI.METHODS From June 1,2018 to June 1,2019,a total of 115 elderly patients who underwent PCI surgery in Anyang Traditional Chinese Hospital due to acute myocardial infarction were collected and grouped according to the principle of comparability between the two groups of general data.57 cases in the control group received cross theoretical health education,58 cases in the observation group added cardiac rehabilitation treatment on the basis of the control group.The two groups of patients were compared for their cardiac function,knowledge level,antioxidant capacity,and exercise endurance.RESULTS After treatment,the maximum oxygen uptake in the observation group was(20.02±2.11)ml/(kg·min),which was higher than that in the control group(16.83±2.04)ml/(kg·min),t=8.240,P<0.001.Duration of exercise was(402.15±16.29)s,which was higher than that of the control group(388.72±15.40)s,t=4.542,P<0.001.The superoxide dismutase in the observation group was(91.47±4.11)U/ml,which was higher than the control group(86.93±4.04)U/ml,t=5.973,P<0.001.The total antioxidant capacity was(14.38±1.10)U/ml,higher than(11.39±2.05)U/ml in the control group,t=9.770,P<0.001.The 6-minute walking test distance of the observation group was(347.05±15.08)m,which was higher than that of the control group(322.85±14.94)m,t=8.644,P<0.001.The left ventricular ejection fraction was(58.28±4.11)%,which was higher than(55.86±4.34)%of the control group,t=3.071,P=0.001.The health knowledge score of the observation group was(109.37±8.25),which was higher than the control group(101.29±7.17),t=5.602,P<0.001.The health belief score was(28.55±3.61),which was higher than the control group(23.57±3.69),t=7.316,P<0.001.Health behavior score was(33.59±4.07),higher than the control group(29.15±3.66),t=6.148,P<0.001.CONCLUSION Trans-theoretical model combined with cardiac rehabilitation can improve cardiac function,anti-oxidation capacity,enhance exercise endurance,and improve the level of knowledge,belief and action in elderly patients with acute myocardial infarction after PCI.