老年心脏外科术后患者早期康复实践

Application of early rehabilitation program in elderly patients undergoing cardiac surgery

目的促进老年心脏外科术后患者康复。方法将79例心脏及大血管疾病择期行心脏外科手术的老年患者分为对照组(42例)与干预组(37例)。对照组行常规康复护理,干预组制订和实施低强度床上早期康复方案。结果干预组术后第7天Barthel指数、出院时Rivermead运动指数显著优于对照组(均P<0.05);两组均未发生康复相关不良事件;干预组康复依从性好者(35.14%),较依从性一般患者(64.86%)体质量更轻、术前内生肌酐清除率更低、有医保率更低(均P<0.05)。结论低强度床上早期康复可提高心脏外科术后老年患者近期运动功能水平,应加强针对性教康教育,提高患者早期康复锻炼依从性。

Objective To promote rehabilitation of elderly patients after cardiac surgery.Methods Totally,79 elderly patients with heart disease or macrovascular disease undergoing scheduled cardiac surgery were divided into a control group(n=42)and an intervention group(n=37).The control group was given routine rehabilitation care,while the intervention group was subjected to a low-intensity in-bed early rehabilitation program.Results The intervention group had better Barthel Index scores on the 7th postoperative day and better Rivermead mobility index scores on discharge(P<0.05 for both).No adverse events occurred during rehabilitation in the two groups.Those with good(35.14%)rehabilitation adherence in the intervention group had lighter body weight,lower endogenous creatinine clearance rate and lower proportion of medical insurance than the patients with moderate(64.86%)rehabilitation adherence(all P<0.05).Conclusion Low-intensity in-bed early rehabilitation program can improve the short-term motor function of elderly patients after cardiac surgery.Targeted education should be strengthened to improve patients'adherence to early rehabilitation exercises.