双心护理结合早期康复策略在急性心肌梗死患者中的应用价值

Application value of psycho-cardiological nursing combined with early rehabilitation strategy in patients with acute myocardial infarction

目的研究双心护理结合早期康复策略在行经皮冠脉介入术(PCI)后的急性心肌梗死患者中的应用价值。方法以随机数字表法将2021年3月至2022年7月在东南大学附属中大医院行PCI的90例急性心肌梗死患者分为2组,各45例。对照组接受早期康复结合常规护理,观察组在对照组干预方法的基础上接受双心护理。比较2组的心功能指标、不良情绪、生活质量和心血管不良事件发生情况。结果术后1个月和3个月,2组的N末端脑钠肽前体水平均较术前降低,且观察组均比同期对照组更低;2组的左室射血分数均较术前增大,且观察组均比同期对照组更大;2组的6分钟步行试验距离均较术前增长,且观察组均比同期对照组更长,上述比较均有统计学差异(P均<0.05)。术后1个月和3个月,观察组的不良情绪评分(汉密尔顿焦虑/抑郁量表)均低于同期对照组(P均<0.05),且2组均低于术前(P均<0.05)。术后3个月,2组的生存质量精简量表各项评分均较术前高(P均<0.05),且观察组均高于对照组(P均<0.05)。观察组的心血管不良事件总发生率低于对照组(P<0.05)。结论双心护理结合早期康复策略可改善行PCI后的急性心肌梗死患者的心功能、不良情绪和生活质量,也可预防心血管不良事件的发生。

Objective To explore the application value of psycho-cardiological nursing combined with early rehabilitation strategy in acute myocardial infarction patients after percutaneous coronary intervention(PCI).Methods Ninety patients with acute myocardial infarction who underwent PCI at Zhongda Hospital Southeast University from March 2021 to July 2022 were divided into two groups using a random number table,with 45 patients in each group.The control group received early rehabilitation combined with routine nursing,while the observation group received psycho-cardiological nursing on the basis of the intervention method of the control group.The cardiac function indicators,negative emotions,quality of life,and the incidence of cardiovascular adverse events were compared between the two groups.Results At 1 and 3 months after operation,the N-terminal pro-brain natriuretic peptide level in both groups decreased compared with the preoperative level,and the observation group showed a lower level than the control group.The left ventricular ejection fraction in both groups increased compared with the preoperative level,and the observation group was greater than the control group.The 6-min walk distance in both groups increased compared with the preoperative level,and the observation group was longer than the control group.The above comparisons were statistically different(all P<0.05).At 1 and 3 months after operation,the negative emotion scores(Hamilton Anxiety/Depression Rating Scale)of the observation group were lower than those of the control group(all P<0.05),and both groups showed lower scores compared with those before operation(all P<0.05).At 3 months after operation,the scores of the Quality of Life Questionnaire-BREF in both groups were higher than those before operation(all P<0.05),and the observation group showed higher scores than the control group(all P<0.05).The total incidence of cardiovascular adverse events in the observation group was lower than that in the control group(P<0.05).Conclusion Psycho-cardiological nursing combined with early rehabilitation strategy can improve the cardiac function,negative emotions,and quality of life of patients with acute myocardial infarction after PCI,and can also prevent the cardiovascular adverse events.