个体化康复运动训练及综合康复指导对急性心肌梗死患者行PCI术后的应用效果观察

Effect observation of individualized rehabilitation exercise training and comprehensive rehabilitation guidance on patients with acute myocardial infarction after PCI

目的 观察个体化康复运动训练及综合康复指导在急性心肌梗死(AMI)行经皮冠状动脉介入术(PCI)后患者中的应用效果。方法 60例急性心肌梗死行PCI术后患者,凭借随机数字表法分为对照组和观察组,各30例。对照组患者术后给予常规护理干预,观察组患者在对照组的基础上实施个体化康复运动训练及综合康复指导。比较两组患者干预前后心功能指标[心输出量(CO)、左心室舒张末期容积(LVEDV)、左心室射血分数(LVEF)]以及术后血糖(空腹血糖、餐后2 h血糖)水平、血脂[低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)、总胆固醇(TC)]水平、生活质量[生理机能(PF)、生理职能(RP)、躯体疼痛(BP)、一般健康状况(GH)、情感职能(RE)、社会功能(SF)、精神健康(MH)、精力(VT)]。结果 干预后,观察组患者LVEDV(128.33±4.54)ml低于对照组的(145.39±4.88)ml,CO(4.86±0.49)L/min、LVEF(57.57±3.65)%高于对照组的(4.37±0.47)L/min、(51.82±3.42)%,差异均具有统计学意义(P<0.05)。观察组患者术后空腹血糖(6.09±0.34)mmol/L、餐后2 h血糖(7.28±0.38)mmol/L、LDL-C(2.19±0.24)mmol/L、TG(4.97±0.33)mmol/L、TC(0.29±0.06)mmol/L均低于对照组的(7.35±0.37)、(8.79±0.42)、(3.59±0.26)、(6.48±0.35)、(1.78±0.23)mmol/L,HDL-C(1.38±0.15)mmol/L高于对照组的(1.09±0.13)mmol/L,差异均具有统计学意义(P<0.05)。观察组患者术后PF、RP、BP、GH、RE、SF、MH、VT评分分别为(95.82±4.99)、(80.55±4.22)、(89.92±5.02)、(88.02±4.98)、(72.55±4.53)、(94.54±3.43)、(88.43±4.54)、(97.32±2.25)分,均高于对照组的(87.55±4.54)、(65.93±3.65)、(59.94±3.54)、(68.82±3.65)、(59.92±3.55)、(85.92±4.88)、(54.35±3.35)、(81.81±4.49)分,差异均具有统计学意义(P<0.05)。结论 对接受PCI术治疗的急性心肌梗死患者实施个体化康复运动训练及综合康复指导,可以使患者心功能显著改善,血糖、血脂水平降低,生活质量提高,具有较为理想的临床效果。

Objective To observe the application effect of individualized rehabilitation exercise training and comprehensive rehabilitation guidance on patients with acute myocardial infarction(AMI) after percutaneous coronary intervention(PCI).Methods A total of 60 patients with acute myocardial infarction after PCI were divided into a control group and an observation group according to random numerical table,with 30 cases in each group.Patients in the control group received conventional nursing interventions after surgery,and patients in the observation group received individualized rehabilitation exercise training and comprehensive rehabilitation guidance on the basis of the control group.Both groups were compared in terms of cardiac function indices [cardiac output(CO),left ventricular end-diastolic volume(LVEDV),left ventricular ejection fraction(LVEF)] before and after intervention,and postoperative glucose(fasting glucose,2 h postprandial glucose) levels,lipid [lowdensity lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),triglyceride(TG),total cholesterol(TC)] levels,quality of life [physical functioning(PF),role-physical(RP),bodily pain(BP),general health(GH),role-emotional(RE),social functioning(SF),mental health(MH),vitality(VT)].Results After the intervention,the observation group had lower LVEDV of(128.33±4.54) ml than(145.39±4.88) ml in the control group;the observation group had CO of(4.86±0.49) L/min and LVEF of(57.57±3.65)%,which were higher than(4.37±0.47) L/min and(51.82±3.42)% in the control group;the differences were all statistically significant(P<0.05).The observation group had postoperative fasting glucose of(6.09±0.34) mmol/L,2 h postprandial glucose of(7.28±0.38) mmol/L,LDL-C of(2.19±0.24) mmol/L,TG of(4.97±0.33) mmol/L,TC of(0.29±0.06) mmol/L,which were lower than(7.35±0.37),(8.79±0.42),(3.59±0.26),(6.48±0.35),and(1.78±0.23) mmol/L in the control group;the observation group had higher HDL-C(1.38±0.15) mmol/L than(1.09±0.13) mmol/L in the control group;the differences were all statistically significant(P<0.05).The postoperative PF,RP,BP,GH,RE,SF,MH,and VT scores in the observation group were(95.82±4.99),(80.55±4.22),(89.92±5.02),(88.02±4.98),(72.55±4.53),(94.54±3.43),(88.43±4.54),and(97.32±2.25) points,which were higher than(87.55±4.54),(65.93±3.65),(59.94±3.54),(68.82±3.65),(59.92±3.55),(85.92±4.88),(54.35±3.35),and(81.81±4.49) points in the control group,and the differences were all statistically significant(P<0.05).Conclusion In patients with acute myocardial infarction treated by PCI,the implementation of individualized rehabilitation exercise training and comprehensive rehabilitation guidance after surgery can significantly improve the cardiac function of patients,reduce the level of blood glucose and blood lipid,and improve the quality of life,which has an ideal clinical effect.