NEM康复路径在妊娠高血压合并急性左心衰竭产妇剖宫产术后的应用

Effects of nutrition-exercise-medicine rehabilitation pathway in pregnant women with gestational hypertension compled with acute left ventricular failure after cesarean section

目的分析营养支持、支运动锻炼联合药物辅助(NEM)康复路径在妊娠高血压合并急性左心衰竭产妇剖宫产术后影响。方法经医院伦理学会批准,选择空军军医大学第二附属医院2018年1月1日—2021年1月1日诊治的妊娠高血压合并急性左心衰竭患者72例。采用计算机随机数字分组法将其分成常规组和NEM组,例数均是36例。常规组患者接受常规康复路径干预,NEM组接受NEM康复路径。均干预7 d。在干预前后评定两组患者疼痛情况、临床疗效、干预满意度、身体维度及住院时间和感染发生情况。结果NEM组及常规组患者在干预前(VAS评分[分别为(6.29±0.24)分、(6.21±0.29)分]差异比较无统计学意义(P>0.05)。NEM组在干预24 h的VAS评分(2.91±0.23)分低于常规组(3.87±0.29)(P<0.05)。NEM组患者临床总有效率高于常规组(P<0.05)。NEM组患者干预总满意率高于常规组(P<0.05)。NEM组上臂肌肉维度(23.69±2.09)cm和腰围(80.29±3.19)cm在干预前与常规组上臂肌肉维度(23.61±2.04)cm和腰围(80.32±3.11)cm比较差异无统计学意义(P>0.05)。NEM组上臂肌肉维度(27.17±4.69)cm和腰围(83.74±4.15)cm在干预后明显大于常规组上臂肌肉维度(25.06±4.61)cm和腰围(81.9±4.12)cm(P<0.05)。NEM组患者住院时间和感染发生率低于常规组(P<0.05)。结论NEM康复路径用于妊娠高血压合并急性左心衰竭产妇剖宫产术后能明显提升临床效果,增加患者身体维度,减轻疼痛,减少住院时间和感染,建议使用。

Objective To investigate the effects of nutrition-exercise-medicine(NEM)rehabilitation pathway in pregnant women with gestational hypertension complicated with acute left ventricular failure after cesarean section.Methods 72 pregnant women with gestational hypertension complicated with acute left ventricular failure undergoing cesarean section were randomLy divided into 2 equal groups:routine group receiving traditional rehabilitation pathway intervention and NEM group receiving NEM rehabilitation pathway intervention.24 h after the intervention visual analogue scale(VAS)was used to evaluate the degree of pain.The clinical symptoms and occurrence of infection were observed.Arm circumference and waist circumference were measured before treatment and 7 d after treatment.Hospital general management satisfaction rating scale was used to evaluate the patients’satisfaction.The length of hospital stay was calculated.Results The baseline VAS score was(6.29±0.24)in the NEM group,not significantly different from that of the routine group[(6.21±0.29),P>0.05].24 h after intervention,the VAS score of the NEM group was(2.91±0.23),significantly lower than that of the routine group[(3.87±0.29),P<0.05].The general efficacy rate of the NEM group was 94.44%,significantly higher than that of the routine group(72.22%,P<0.05).The general patient satisfaction rate of the NEM group was 97.22%,significantly higher than that of the routine group(75%,P<0.05).The baseline upper arm circumference and waist circumference of the NEM group were(23.69±2.09)cm and(80.29±3.19)cm respectively,not significantly different from those of the routine group[(23.61±2.04)cm and(80.32±3.11)cm respectively,both P<0.05].7 d after intervention,the upper arm circumference and waist circumference of the NEM group were(27.17±4.69)cm and(83.74±4.15)cm,both significantly higher than those of the routine group[(25.06±4.61)cm and(81.9±4.12)cm respectively,both P<0.05].The hospital stay length of the NEM group was(6.72±1.06)d,significantly shorter than that of the routine group[(12.10±1.01)d,P<0.05].The infection rate of the NEM group was11.11%,significantly lower than that of the routine group(38.89%,P<0.05).Conclusion Application of NEM rehabilitation pathway in pregnant women after cesarean section with gestational hypertension complicating acute left ventricular failure can effectively improve the physical circumferences,alleviate pain,shorten the hospital stay length,and reduce the infection rate.