心脏康复护理对急性心肌梗死经皮冠脉介入术后患者心功能影响的meta分析

Effect of cardiac rehabilitation nursing on cardiac function of patients with acute myocardial infarction after percutaneous coronary intervention:a meta-analysis

目的:以系统评价的方法评估心脏康复护理模式对急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术后心功能的影响。方法:检索数据库有关心脏康复对AMI患者PCI术后心功能影响的文献,包括中国知网(CNKI)、维普数据库(VIP)、万方数据库、中国生物医学文献数据库(CBM)、PubMed、Embase等,检索时间截止至2023年1月,筛选符合要求的随机对照研究。结果:共纳入11项研究,结果显示:心脏康复组左室射血分数(MD=5.26,95%CI(3.70,6.82),P=0.001)、6min步行距离(MD=61.02,95%CI(27.43,94.62),P=0.001)、摄氧量峰值(MD=3.64,95%CI(2.38,4.90),P=0.001)、无氧阈(MD=3.08,95%CI(1.47,4.69),P=0.001)均显著高于对照组;左室收缩末期内径(MD=-1.83,95%CI(-2.36,-1.30),P=0.001)、左室舒张末期内径(MD=-3.43,95%CI(-5.01,-1.85),P=0.001)均显著小于对照组。结论:急性心肌梗死患者PCI术后采用心脏康复护理可显著改善心功能,增加运动耐量,改善生活质量,但由于部分指标有较高的异质性,仍需进一步评估。

Objective:To assess the effect of cardiac rehabilitation nursing mode on cardiac function in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI)with a systematic review method.Methods:We searched databases,including CNKI,VIP,Wanfang,CBM,PubMed,Embase etc.,for literature on influence of cardiac rehabilitation on cardiac function in AMI patients after PCI before Jan 2023.Eligible randomized controlled tests(RCTs)were screened.Results:A total of 11 studies were enrolled and the results indicated that compared with control group,there were significant rise in left ventricular ejection fraction(MD=5.26,95%CI(3.70,6.82),P=0.001),6min walking distance(MD=61.02,95%CI(27.43,94.62),P=0.001),peak oxygen uptake(O 2,MD=3.64,95%CI(2.38,4.90),P=0.001)and anaerobic threshold(AT,MD=3.08,95%CI(1.47,4.69),P=0.001),and significant reductions in left ventricular end-systolic diameter(MD=-1.83,95%CI(-2.36,-1.30),P=0.001)and left ventricular end-diastolic diameter(MD=-3.43,95%CI(-5.01,-1.85),P=0.001)in cardiac rehabilitation group.Conclusion:Cardiac rehabilitation nursing can significantly improve cardiac function,exercise endurance and quality of life in patients with acute myocardial infarction after PCI.However,due to high heterogeneity of some indexes,further evaluation is still needed.