早期心脏康复护理在急性心肌梗死PCI术后患者中的应用效果

Application effects of early cardiac rehabilitation nursing in patients with acute myocardial infarction after PCI

目的:观察早期心脏康复护理在急性心肌梗死(AMI)经皮冠状动脉介入术(PCI)后患者中的应用效果。方法:选取2019年6月至2020年10月该院收治的61例AMI患者进行前瞻性研究,按照随机数字表法分为对照组(n=30)和观察组(n=31)。对照组采用常规术后心脏康复护理,观察组采用早期心脏康复护理,比较两组护理前后心室舒张功能指标[B型脑钠肽(BNP)、左心室射血分数(LVEF)、左心室舒张早期和晚期充盈速度比值(E/A)、心肌耗氧量(CMO)]水平、心肺功能指标[最大摄氧量(VO_(2)max)、二氧化碳通气当量斜率(VE/VCO_(2)slope)、无氧阈(AT)、最大代谢当量(METmax)]水平和心脏不良事件发生率。结果:护理后,观察组BNP水平低于对照组,LVEF、E/A、CMO水平均高于对照组,差异有统计学意义(P<0.05);护理后,观察组VO_(2)max、METmax、AT水平高于对照组,VE/VCO_(2)slope水平低于对照组,差异有统计学意义(P<0.05);观察组心脏不良事件发生率为19.36%,低于对照组的43.33%,差异有统计学意义(P<0.05)。结论:早期心脏康复护理应用于AMI经PCI术后患者可改善心室舒张功能指标和心肺功能指标水平,降低心脏不良事件发生率,其效果优于常规术后心脏康复护理。

Objective:To observe application effects of early cardiac rehabilitation nursing in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods:61 patients with AMI admitted to this hospital from June 2019 to October 2020 were selected for the prospective study,and were divided into control group(n=30)and observation group(n=31)according to random number table method.The control group received conventional postoperative cardiac rehabilitation nursing,while the observation group was given the early cardiac rehabilitation nursing.The ventricular diastolic function index level[B-type natriuretic peptide(BNP),left ventricular ejection fraction(LVEF),left ventricular diastolic early and late filling velocity ratio(E/A),myocardial oxygen consumption(CMO)],the cardiopulmonary function index levels[maximal oxygen uptake(VO_(2)max),carbon dioxide ventilation equivalent slope(VE/VCO_(2)slope),anaerobic threshold(AT),maximum metabolic equivalent(METmax)]levels,and the incidence of adverse cardiac events were compared between the two groups before and after the nursing.Results:After the nursing,the BNP level in the observation group was lower than that in the control group;the levels of LVEF,E/A and CMO were higher than those in the control group;and the differences were statistically significant(P<0.05).After the nursing,the levels of VO_(2)max,METmax and AT in the observation group were higher than those in the control group;the level of VE/VCO_(2)slope was lower than that in the control group;the differences were statistically significant(P<0.05).Further,the incidence of cardiac adverse events in the observation group was 19.36%,which was lower than 43.33%in the control group,and the difference was statistically significant(P<0.05).Conclusions:The early cardiac rehabilitation strategy applied to the patients with AMI after PCI can improve the levels of cardiac function indexes and the cardiopulmonary function indexes,and reduce the incidence of adverse cardiac events.Moreover,it is superior to conventional postoperative cardiac rehabilitation nursing.