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基于个体化心脏康复的老年心肌梗死患者心脏康复护理探索

Exploration of cardiac rehabilitation nursing for elderly patients with myocardial infarction based on individualized cardiac rehabilitation.

作者信息

Liu Hua-Ning, Gao Bo

机构信息

Department of Geriatrics, General Hospital of the YangTze River Shipping, Wuhan Brain Hospital, Wuhan 430015, Hubei Province, China.

Department of Cardiology, Suizhou Central Hospital, Affiliated Hospital of Hubei University of Medicine, Suizhou 441300, Hubei Province, China.

出版信息

World J Clin Cases. 2024 Jan 16;12(2):256-266. doi: 10.12998/wjcc.v12.i2.256.

Abstract

BACKGROUND

Myocardial infarction is a high-risk condition prevalent among the elderly population, often leading to adverse clinical manifestations such as reduced cardiopulmonary function, anxiety, and depression post-surgery. Consequently, cardiac rehabilitation holds immense importance in mitigating these complications.

AIM

To evaluate the effect of individualized cardiac rehabilitation on blood pressure variability (BPV) and baroreflex sensitivity (BRS) in elderly patients with myocardial infarction.

METHODS

A cohort of 74 elderly patients diagnosed with myocardial infarction and admitted to our hospital between January 2021 and January 2022 were subjected to random selection. Subsequently, all patients were divided into two groups, namely the research group ( = 37) and the control group ( = 37), utilizing the number table method. The control group received conventional drug treatment and nursing guidance intervention, while the study group underwent individualized cardiac rehabilitation in addition to the interventions received by the control group. All patients were continuously intervened for 12 wk, and the BPV of these two groups in the 1 wk (T0), the 4 wk (T1) and the 12 wk (T2) were compared, BRS, changes in cardiopulmonary function measures, and adverse cardiovascular events.

RESULTS

Of 24 h diastolic BPV, 24 h systolic BPV, carbon dioxide ventilation equivalent slope of the research group were lower than those of the control group at T1 and T2, BRS, peak heart rate and systolic blood pressure product, 1 min heart rate recovery were higher than those of the control group, and the incidence of adverse events in the research group was lower than that of the control group, the difference was statistically significant ( < 0.05).

CONCLUSION

In this study, we found that after individualized cardiac rehabilitation in elderly patients with myocardial infarction, BPV and BRS can be effectively improved, cardiac function is significantly enhanced, and a better prognosis is obtained.

摘要

背景

心肌梗死是老年人群中普遍存在的高危病症,常导致术后心肺功能下降、焦虑和抑郁等不良临床表现。因此,心脏康复对于减轻这些并发症具有极其重要的意义。

目的

评估个体化心脏康复对老年心肌梗死患者血压变异性(BPV)和压力反射敏感性(BRS)的影响。

方法

随机选取2021年1月至2022年1月期间我院收治的74例诊断为心肌梗死的老年患者。随后,采用数字表法将所有患者分为两组,即研究组(n = 37)和对照组(n = 37)。对照组接受常规药物治疗和护理指导干预,而研究组除接受对照组的干预外,还进行个体化心脏康复。所有患者连续干预12周,比较两组在1周(T0)、4周(T1)和12周(T2)时的BPV、BRS、心肺功能指标变化及心血管不良事件。

结果

研究组在T1和T2时的24小时舒张压BPV、24小时收缩压BPV、二氧化碳通气当量斜率均低于对照组,BRS、心率峰值和收缩压乘积、1分钟心率恢复均高于对照组,且研究组不良事件发生率低于对照组,差异有统计学意义(P < 0.05)。

结论

本研究发现,老年心肌梗死患者进行个体化心脏康复后,BPV和BRS可有效改善,心脏功能显著增强,预后更佳。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53e1/10835703/91002db4642f/WJCC-12-256-g001.jpg

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