专科护士为主导的多学科协作康复护理对心脏瓣膜置换患者术后康复的影响

Effect of multidisciplinary collaborative rehabilitation nursing led by specialized nurses on postoperative recovery of patients undergoing heart valve replacement

目的探讨专科护士为主导的多学科协作康复护理对心脏瓣膜置换患者术后康复的影响。方法选择2021年6月至2023年2月于河南省胸科医院行心脏瓣膜置换术治疗的96例患者为研究对象,按照护理方式不同将患者分为对照组和观察组,每组48例。对照组患者给予常规护理干预,观察组患者给予专科护士为主导的多学科协作康复护理干预。记录2组患者术后首次排气时间、首次排便时间、首次下床活动时间及重症监护时间、住院时间;于出院时、术后6个月时,采用6 min步行距离试验和明尼苏达心力衰竭生活质量量表(MLHFQ)评估患者的心功能状态和生活质量;术后6个月,记录2组患者不良心脏事件发生率。结果观察组患者首次排气时间、首次排便时间、首次下床时间、重症监护时间和住院时间显著短于对照组(P<0.05)。出院时,2组患者6 min步行距离比较差异无统计学意义(P>0.05);术后6个月,2组患者6 min步行距离显著长于出院时,且观察组患者6 min步行距离显著长于对照组(P<0.05)。出院时,2组患者MLHFQ评分比较差异无统计学意义(P>0.05);术后6个月,2组患者MLHFQ评分显著低于出院时,且观察组患者MLHFQ评分显著低于对照组(P<0.05)。对照组患者发生不良心脏事件8例(16.67%),观察组患者发生不良心脏事件2例(4.17%);观察组患者不良心脏事件发生率显著低于对照组(χ^(2)=4.019,P<0.05)。结论专科护士为主导的多学科协作康复护理可缩短心脏瓣膜置换患者术后恢复时间,改善心功能和生活质量,减少不良心脏事件的发生。

Objective To explore the effect of multidisciplinary collaborative rehabilitation nursing led by specialized nurses on the postoperative recovery of patients undergoing heart valve replacement.Methods Totally 96 patients who underwent heart valve replacement at Henan Provincial Chest Hospital from June 2021 to February 2023 were selected as the research subjects.Patients were divided into control group and observation group according to different nursing methods,with 48 patients in each group.Patients in the control group accepted routine nursing intervention,and patients in the observation group accepted multidisciplinary collaborative rehabilitation nursing intervention led by specialized nurses.After the operation,the time of first anus exhaust,the time of first anus defecation and the time of first getting out of bed,duration of intensive care and length of hospital stay were recorded in the two groups.Patients'heart function and quality of life were evaluated by a 6-minute walk test and Minnesota living with Heart Failure questionnaire(MLHFQ)at discharge and follow-up for 6 months.After 6 months of follow-up,the incidence of adverse cardiac events in the two groups was recorded.Results The time of first anus exhaust,the time of first anus defecation and the time of first getting out of bed,duration of intensive care and length of hospital stay of patients in the observation group were significantly shorter than those in the control group(P<0.05).At discharge,there was no statistically significant difference in the 6-minute walk distance of patients between the two groups(P>0.05).At 6 months postoperatively,the 6-minute walk distances of patients in both groups were significantly higher than those at discharge,and the 6-minute walk distance of patients in the observation group was significantly greater than that in the control group(P<0.05).At discharge,there was no statistically significant difference in the MLHFQ scores of patients between the two groups(P>0.05).At 6 months postoperatively,the MLHFQ scores of patients in both groups were significantly lower than those at discharge,and the MLHFQ scores of patients in the observation group were significantly lower than those in the control group(P<0.05).The adverse cardiac events in the control group and observation group were 8(16.67%)and 2(4.17%),respectively;the incidence of adverse cardiac events of patients in the observation group was significantly lower than that in the control group(χ^(2)=4.019,P<0.05).Conclusion Multidisciplinary collaborative rehabilitation nursing led by specialized nurses can shorten postoperative recovery time,improve heart function and quality of life,and reduce the occurrence of adverse cardiac events in patients undergoing heart valve replacement.