康复路径基于专科护士为导向的延续护理在急性心肌梗死患者心脏康复中的应用

Application of rehabilitation path combined with continuous nursing guided by specialist nurses in cardiac rehabilitation of acute myocardial infarction

目的:探讨康复路径结合基于专科护士为导向的延续护理在急性心肌梗死患者心脏康复中应用。方法:选取2017年8月至2018年8月华中科技大学同济医学院附属同济医院收治的急性心肌梗死患者102例,随机分为两组,对照组应用常规干预,研究组应用康复路径基于专科护士为导向的延续护理。观察并比较两组干预后恢复情况、住院期间卧床时间及平均住院时间、出院后相关心血管不良事件发生情况及出院后不同时间点下的运动耐力情况。结果:研究组心功能分级情况、左心室射血分数(LVEF)水平恢复情况、改良Barthel指数(MBI)评分、卧床时间及平均住院时间、出院后随访期间的相关心血管不良事件发生比例、不同时间点下运动耐力情况均显著优于对照组,差异有统计学意义(均 P<0.05)。 结论:急性心肌梗死患者心脏康复过程中应用康复路径基于专科护士为导向的延续护理,能有效缩短患者的住院时间、改善患者的心功能分级与LVEF水平,同时有效降低患者出院后发生相关心血管不良事件风险。

Objective To explore the application of rehabilitation pathway combined with continuing nursing based on specialist nurses in cardiac rehabilitation of patients with acute myocardial infarction.Methods A total of 102 patients with acute myocardial infarction admitted to Tongji Hospital Affiliated to Huazhong University of Science and Technology from August 2017 to August 2018 were randomly divided into two groups.The control group was treated with routine intervention, while the research group was treated with rehabilitation pathway combined with continuing nursing based on specialist nurses.The short-term recovery before discharge, bed-rest time during hospitalization and average length of hospitalization, occurrence of related cardiovascular adverse events after discharge and exercise endurance at different time points after discharge were observed and compared between the two groups.Results Cardiac function grade, left ventricular ejection fraction (LVEF) level recovery, modified Barthel index (MBI) score, bed time and average length of stay, the incidence rate of cardiovascular adverse events during follow-up after discharge, and exercise endurance at different time points of the research group were all significantly better than the control group, with statistically significant differences (P<0.05).Conclusions In the cardiac rehabilitation process of patients with acute myocardial infarction, the application of the rehabilitation path based on the continuous nursing guided by specialist nurses can effectively shorten the length of stay of patients, improve the cardiac function classification and LVEF level of patients, and effectively reduce the risk of cardiovascular adverse events after discharge.