急性ST段抬高型心肌梗死患者急诊PCI术后采用Ⅰ期心脏康复护理效果评价

The effect assessment on the one-stage cardiac rehabilitation nursing in patients with acute ST-segment elevation myocardial infarction after emergency percutaneous coronary intervention

目的探讨急性ST段抬高型心肌梗死(STEMI)患者在急诊经皮冠状动脉介入(PCI)术后给予Ⅰ期心脏康复护理的效果。方法选取2018年12月至2019年12月我院收治的急性STEMI患者94例,按随机数字表法分为对照组和观察组,每组各47例。对照组PCI术后给予常规护理,观察组术后在对照组的基础上给予Ⅰ期心脏康复护理。比较两组血脂、心功能、6 MWT及心血管不良事件(MACE)发生情况。结果出院时对照组血脂指标与治疗前无明显差异(P>0.05);观察组总胆固醇(TC)、甘油三脂(TG)、低密度脂蛋白胆固醇(LDL-C)低于治疗前,高密度脂蛋白胆固醇(HDL-C)高于治疗前,差异有统计学意义(P<0.05);组间比较,差异有统计学意义(P<0.05)。出院时两组左心室射血分数(LVEF)高于治疗前,左心室舒张末期直径(LVDD)低于治疗前,差异有统计学意义(P<0.05);组间比较,差异有统计学意义(P<0.05)。出院时观察组6 MWT长于对照组,两组比较,差异有统计学意义(P<0.05)。对照组MACE总发生率高于观察组,两组比较,差异有统计学意义(P<0.05)。结论急性STEMI急诊术后采用Ⅰ期心脏康复护理,能够改善患者血脂及心功能,提高运动耐力,减少MACE发生。

Objective To study the effect of one-stage cardiac rehabilitation nursing in patients with acute ST-segment elevation myocardial infarction(STEMI)after the emergency percutaneous coronary intervention(PCI).Methods A total of 94 acute STEMI patients admitted to our hospital from December 2018 to December 2019 were selected and divided into the control group and the observation group by random number table method,with 47 cases in each group.The control group was given routine care after PCI.The observation group was given one-stage cardiac rehabilitation training on the basis of the treatment in the control group.Blood lipids,cardiac function,6 MWT,and major adverse cardiovascular events(MACE)were compared between the two groups.Results The blood lipid indexes of the control group at discharge were not significantly different from those before treatment(P>0.05).The total cholesterol(TC),triglyceride(TG),and low-density lipoprotein cholesterol(LDL-C)of the observation group were slightly lower than those before treatment,and the high-density lipoprotein cholesterol(HDL-C)was higher than that before treatment,with statistically significant differences(P<0.05).The differences between the groups were statistically significant(P<0.05).At discharge,the left ventricular ejection fraction(LVEF)of the two groups were higher than those before treatment and left ventricular end-diastolic diameter(LVDD)were lower than those before treatment,and the differences were statistically significant(P<0.05).The differences between the two groups were statistically significant(P<0.05).The 6MWD in the observation group was longer than that in the control group,and the difference between the two groups was statistically significant(P<0.05).The total incidence of MACE total in the control group was higher than that in the observation group,and the difference between the two groups was statistically significant(P<0.05).Conclusion One-stage cardiac rehabilitation in acute STEMI patients after emergency surgery can improve the patients′blood lipid and heart function,improve exercise tolerance,and decrease MACE incidence.