叙事护理联合心脏康复运动处方在中青年急性心肌梗死PCI术后的应用研究

Research on the Application of Narrative Nursing Combined with Cardiac Rehabilitation Exercise Prescription in Young and Middle-Aged Patients with Acute Myocardial Infarction after PCI

目的叙事护理联合心脏康复运动处方在中青年急性心肌梗死经皮冠状动脉介入治疗(PCI)术后的应用效果。方法选取2020年8月—2023年1月本院收治的100例中青年急性心肌梗死患者为研究对象,按照随机数字表法将其分为对照组与观察组,各50例。对照组采用心脏康复运动处方干预与基础护理,观察组在对照组基础上采用叙事护理,两组均接受急性心肌梗死PCI手术。评价两组患者的心理状态、心功能水平、动脉僵硬度、生存质量。结果干预后,两组焦虑自评量表、抑郁自评量表评分均低于干预前,且观察组低于对照组,差异有统计学意义(P<0.05)。出院3个月后,两组N末端脑钠肽前体(NT-proBNP)、左室射血分数(LVEF)水平均高于出院时,6 min步行距离(6MWD)长于出院时,且观察组NT-proBNP、LVEF水平均高于对照组,6MWD长于对照组,差异有统计学意义(P<0.05)。出院1、3个月后,观察组的运动处方依从性均高于对照组,组间差异有统计学意义(P<0.05)。出院3个月后,观察组西雅图心绞痛生存质量表(SAQ)疾病知晓度、疗效满意度均高于对照组,组间差异有统计学意义(P<0.05);两组SAQ量表其余维度评分比较,组间差异无统计学意义(P>0.05)。结论中青年急性心肌梗死PCI术后采用叙事护理联合心脏康复运动处方可提高患者的运动依从性水平,调节患者负面情绪状态,改善患者心功能与生活质量。

Objective To investigate the effect of narrative nursing combined with cardiac rehabilitation exercise prescription after percutaneous coronary intervention(PCI)in young and middle-aged patients with acute myocardial infarction.Methods A total of 100 young and middle-aged patients with acute myocardial infarction admitted to our hospital from August 2020 to January 2023 were selected as the research objects.According to the random number table method,they were divided into a control group and an observation group,with 50 cases in each group.The control group received cardiac rehabilitation exercise prescription intervention and basic nursing,while the observation group received narrative nursing on the basis of the control group.Both groups received PCI surgery for acute myocardial infarction.The psychological status,cardiac function,arterial stiffness and quality of life of the two groups were evaluated.Results After intervention,the scores of self-Rating Anxiety Scale and Self-Rating Depression Scale of the two groups were lower than those before intervention,and those of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).Three months after discharge,the levels of N-terminal pro-brain natriuretic peptide(NT-proBNP)and left ventricular ejection fraction(LVEF)in the two groups were higher than those at discharge,and the 6-minute walk distance(6MWD)was longer than that at discharge.The levels of NT-proBNP and LVEF in the observation group were higher than those in the control group,and the 6MWD was longer than that in the control group.The difference was statistically significant(P<0.05).At 1 and 3 months after discharge,the exercise prescription compliance of the observation group was higher than that of the control group,and the difference between the two groups was statistically significant(P<0.05).Three months after discharge,Seattle Angina Pectoris Quality of Life Questionnaire(SAQ)disease awareness and efficacy satisfaction of the observation group were higher than those of the control group,and the differences between the two groups were statistically significant(P<0.05).There was no significant difference in the scores of other dimensions of SAQ between the two groups(P>0.05).Conclusion Narrative nursing combined with cardiac rehabilitation exercise prescription can improve exercise compliance in young and middle-aged patients with acute myocardial infarction after PCI surgery,regulate their negative emotional state,and improve their cardiac function and quality of life.