基于ERAS理念的康复锻炼在起搏器植入术患者中的应用研究

Application of rehabilitation exercise based on ERAS concept in patients undergoing pacemaker implantation

目的探讨基于快速康复外科(ERAS)理念的康复锻炼在起搏器植入术患者中的应用效果。方法选取2020年1-12月该院心血管内科收治的首次行双腔起搏器植入患者128例,根据住院病区分为干预组(65例)和对照组(63例)。2组均给予常规护理,干预组在常规护理基础上采用基于ERAS的康复锻炼计划进行干预,比较2组运动自我效能量表(SEE)、肩关节疼痛与功能障碍指数(SPADI)评分及并发症发生情况。结果2组术后切口出血、皮下血肿及电极脱位发生率比较,差异无统计学意义(P>0.05)。2组术前SEE评分比较,差异无统计学意义(P>0.05)。2组术后SEE评分比较,差异有统计学意义(P<0.05)。干预组术后SEE评分高于术前,差异有统计学意义(P<0.05)。2组术后SPADI总分及各项评分比较,差异有统计学意义(P<0.05)。结论基于ERAS理念的康复锻炼可提高起搏器植入术患者的运动自我效能,降低患者肩关节疼痛发生率,促进患者术肢肩关节功能恢复,值得临床推广应用。

Objective To explore the effect of rehabilitation exercise based on the concept of rapid reha-bilitation surgery(ERAS)in patients undergoing pacemaker implantation.Methods From January to Decem-ber 2020,128 patients who received dual chamber pacemaker implantation for the first time in the cardiovascu-lar department of the hospital were selected.They were divided into intervention group(65 cases)and control group(63 cases)according to inpatient area.Both groups were given routine nursing care.The intervention group was intervened with ERAS based rehabilitation exercise plan on the basis of routine nursing care.The scores of Exercise Self efficacy Scale(SEE),Shoulder Pain and Disability Index(SPADI)and complications were compared between the two groups.Results There were no significant differences in the incidences of in-cision hemorrhage,subcutaneous hematoma and electrode dislocation between the two groups(P>0.05).There was no significant difference in preoperative SEE scores between the two groups(P>0.05).There was statistically significant difference in the postoperative SEE scores between the two groups(P<0.05).The scores of SEE in the intervention group after operation were higher than those before operation,and the differ-ence was statistically significant(P<0.05).There were statistically significant differences in SPADI total score and various scores between the two groups(P<0.05).Conclusion Rehabilitation exercise based on ERAS concept can improve the self-efficacy of patients with pacemaker implantation,reduce the incidence of shoulder joint pain,and promote the recovery of shoulder joint function of patients with pacemaker implanta-tion,which is worthy of clinical promotion and application.