互联网+背景下智慧护理的构建及其在心脏移植术后患者康复期间的应用

Construction of intelligent nursing in the context of Internet plus and its application in the rehabilitation of patients after heart transplantation

目的 构建互联网+背景下智慧护理系统,并探讨其在心脏移植术后患者康复期间的应用效果。方法 选取2020年6月至2022年6月郑州大学第一附属医院心血管外五科收治的60例心脏移植术后患者作为研究对象,按简单随机化法分为对照组和观察组各30例。对照组患者采取常规护理,观察组患者采取互联网+背景下智慧护理,均护理3个月。统计两组患者的康复指标,比较护理3个月后两组患者的康复锻炼依从性、并发症及护理前、护理3个月后正性负性情绪量表(PANAS)评分、心功能[左心室射血分数(LVEF)、左心室舒张末期容积指数(LVEDVI)、舒张早期与晚期二尖瓣血流峰值速度比值(E/A)],并于护理后6个月、12个月随访生存率。结果 护理3个月后,观察组患者的康复锻炼依从性为86.67%,明显高于对照组的60.00%,差异有统计学意义(P<0.05);护理3个月后,观察组患者的负性情绪评分为(20.22±2.17)分,明显低于对照组的(23.47±2.48)分,正性情绪评分为(33.45±3.46)分,明显高于对照组的(27.76±3.21)分,差异均有统计学意义(P<0.05);护理3个月后,观察组患者的LVEF、E/A分别为(50.52±4.74)%、1.02±0.23,明显高于对照组的(45.99±4.33)%、0.85±0.20,LVEDVI为(48.51±4.42) mL/m2,明显低于对照组的(53.79±4.66) m L/m2,差异均有统计学意义(P<0.05);观察组患者的拔管时间、ICU观察时间、住院时间、首次下床时间分别为(7.12±1.34) d、(5.30±0.58) d、(18.23±3.19) d、(2.96±0.63) d,明显短于对照组的(11.56±2.21) d、(10.04±1.12) d、(26.69±4.45) d、(5.17±0.70) d,差异均有统计学意义(P<0.05);护理3个月后,观察组患者的并发症总发生率为6.67%,明显低于对照组的33.33%,差异有统计学意义(P<0.05);护理后6个月、12个月,观察组患者的生存率分别为86.67%、80.00%,与对照组的80.00%、70.00%比较差异均无统计学意义(P>0.05)。结论 互联网+背景下智慧护理有助于缓解心脏移植术后患者康复期间的负面情绪,提高康复锻炼依从性,改善心功能,缩短住院时间。

Objective To build an intelligent nursing system in the context of Internet plus,and explore its application effect in the rehabilitation of patients after heart transplantation.Methods A total of sixty patients admitted to the Department of Cardiovascular Surgery,the First Affiliated Hospital of Zhengzhou University from June 2020 to June2022 were selected as the research subjects and randomly divided into a control group and an observation group(n=30 in each group) according to a simple randomization method.The patients in the control group received conventional nursing,and the patients in the observation group received intelligent nursing in the context of Internet plus,for 3 months.The rehabilitation indicators of the two groups of patients were statistically analyzed,and the compliance with rehabilitation exercise,complications,and scores on the Positive and Negative Affect Schedule(PANAS) before and after 3months of nursing were compared between the two groups of patients,as well as the cardiac function [left ventricular ejection fraction(LVEF),left ventricular end-diastolic volume index(LVEDVI),and the ratio of peak early diastolic and late diastolic mitral flow velocity(E/A)] before and after 3 months of nursing.The survival rate was followed up at 6 and12 months after nursing.Results After 3 months of nursing,the compliance rate with rehabilitation exercise in the observation group was 86.67%,which was significantly higher than 60.00% in the control group(P<0.05);the negative emotion score in the observation group was(20.22±2.17) points,which was significantly lower than(23.47±2.48) points in the control group;the positive emotion score in the observation group was(33.45±3.46) points,which was significantly higher than(27.76±3.21) points in the control group;the differences were statistically significant(P<0.05).After 3 months of nursing,the LVEF and E/A in the observation group were(50.52±4.74)%,1.02±0.23,which were significantly higher than(45.99 ± 4.33)%,0.85 ± 0.20 in the control group;the LVEDVI in the observation group was(48.51±4.42) mL/m2,which was significantly lower than(53.79±4.66) m L/m2in the control group;the differences were statistically significant(P<0.05).The extubation time,ICU observation time,length of hospital stay,and time of the first out-of-bed activity in the observation group were(7.12±1.34) days,(5.30±0.58) days,(18.23±3.19) days,and(2.96±0.63) days,respectively,which were significantly shorter than(11.56±2.21) days,(10.04±1.12) days,(26.69±4.45) days,and(5.17±0.70) days in the control group(P<0.05).After 3 months of nursing,the total incidence rate of complications in the observation group was 6.67%,which was significantly lower than 33.33% in the control group(P<0.05).After6 months and 12 months of nursing,the survival rate in the observation group was 86.67% and 80.00%,respectively,which was not significantly different from 80.00% and 70.00% in the control group(P>0.05).Conclusion In the context of Internet plus,intelligent nursing can help alleviate the negative emotions of patients after heart transplantation during rehabilitation,improve the compliance of rehabilitation exercise,improve cardiac function,and shorten the length of hospital stay.