介入治疗后急性心肌梗死患者早期心脏康复护理的临床疗效

Clinical efficacy of early cardiac rehabilitation care for patients with acute myocardial infarction after interventional therapy

目的探究急性心肌梗死患者介入治疗后通过早期心脏康复护理是否会对患者临床疗效和后产生有利影响。方法将2020年1月—2021年6月东部战区总医院秦淮医疗区纳入研究的112名患者随机均分为对照组和试验组,对照组的56名患者在经桡动脉或股动脉行经皮冠状动脉介入治疗心肌梗死后实施常规护理,试验组的56名患者实施早期心脏康复护理。收集对照组和试验组一般资料用来判断两组间是否具有可比性。对患者护理干预前和干预后2周进行心功能评分和心脏彩色超声检查,心脏彩超检查包括每搏输出量(SV),左心室射血分数(LVEF),和左心室舒张末期直径(LVEDD)。通过抑郁自评量表、焦虑自评量表评分、Barthel指数来评估患者在护理干预前后的临床疗效以及患者的心理状态、生活质量和日常生活能力。此外还对患者接受护理干预后并发症的发生情况和护理满意度进行收集分析。结果心功能分级评分的检测中,对照组和试验组在护理后的心功能评分均降低,试验组的心功能评分(1.00±0.00)显著低于对照组的心功能评分(2.05±0.62),试验组在护理后的SV为(62.64±10.69)mL显著高于对照组的SV(54.02±9.37)mL,LVEF(59.05±4.93)%以及也显著高于对照组(53.55±4.82)%,而LVEDD(49.00±2.87)mm则低于对照组(52.09±3.97)mm,两组差异有统计学意义(P<0.05)。在护理干预实施后对照组和试验组患者的SAS、SDS评分均下降,但试验组降幅明显大于对照组,Barthel指数均升高,但试验组的增幅显著高于对照组(P<0.05)。在满意度方面,对照组患者的满意率为82.14%,试验组的为96.43%。不良反应发生情况方面,43(76.79%)例患者显著高于试验组的23(41.07%)例患者(P<0.05)。结论急性心肌梗死患者经皮冠状动脉介入治疗后早期心脏康复护理能有效改善患者心功能恢复,缓解患者焦虑抑郁等心理问题,降低不良反应发生率,提高患者满意度,增加患者对医务人员的信任和治疗依从性,为患者带来良好预后。

Objective To investigate the effects of early cardiac rehabilitation care after interventional treatment on the clinical outcome and prognosis in patients with acute myocardial infarction.Methods 112 patients with acute myocardial infarction underwent percutaneous coronary intervention(PCI)and then were randomLy divided into 2 equal groups:control group were given conventional care and experimental group were given early cardiac rehabilitation care.Relevant clinical data were collected.The patients’cardiac function classification and cardiac colour ultrasound indices were assessed before and 2 weeks after the nursing intervention.Cardiac colour ultrasound was performed to examined the stroke volume(SV),left ventricular ejection fraction(LVEF),and left ventricular end-diastolic diameter(LVEDD).Self-rating Anxiety Scale(SAS)and Self-rating depression scale(SDS)were used to assess the levels of anxiety and depression.Patients’Barthel Index was assessed by means of a translated Chinese version of the quantitative Barthel scale.In addition,the incidence of adverse reactions and patient self-assessment of their satisfaction with the care after the nursing intervention were collected.Results There were no significant differences in relevant clinical data between these 2 groups.The cardiac function scores after 2 weeks of nursing intervention of the these 2 groups were both significantly decreased.The cardsiac function score after nursing intervention of the experimental group was(1.00±0.00),significantly lower than that of the control group[(2.05±0.62),P<0.05].The levels of SV and LVEF after nursing intervention of the experimental group were(62.64±10.69)mL and(59.05±4.93)%respectively,both significantly higher than those of the control group[(54.02±9.37)mL and(53.55±4.82%)respectively,both P<0.05].The level of LVEDD after nursing intervention of the experimental group was(49.00±2.87)mm,significantly shorter than that of the control group[(52.09±3.97)mm,P<0.05].The levels of SAS and SDS after nursing intervention of these2 groups all significantly decreased,and the decreasing amplitudes of the experimental groups were significantly greater than those of the control group.The level of Barthel index after nursing intervention of these 2 groups increased significantly and the increasing amplitude of the experimental group was significantly greater than that of the control group(P<0.05).The incidence rate of adverse events of the control group was 76.73%,significantly higher than that of the experimental group(P<0.05).The satisfaction rate of the experimental group was 96.43%,significantly higher than that of the control group(82.14%,P<0.05).Conclusion Early cardiac rehabilitation care after PCI in patients with acute myocardial infarction can effectively improve the recovery of cardiac function,relieve anxiety and depression and other psychological problems,reduce the incidence of adverse reactions,improve satisfaction and treatment compliance,thus bringingbetterprognosis for patients.