Zhou Yi, Wu Xiaolan, Qin Chengting, Tong Youni, Tian Shuang, Huang Xiaoli
Altern Ther Health Med. 2025 Jan;31(1):452-458.
Acute myocardial infarction is the myocardial necrosis caused by acute and persistent ischemia and hypoxia of coronary arteries. It can be complicated with arrhythmia, shock or heart failure, and often can endanger life. The disease is most common in Europe and the United States, where about 1.5 million heart attacks occur each year. China has shown a clear upward trend in recent years, with at least 500 000 new cases and at least 2 million new cases every year. Cardiac rehabilitation nursing is a kind of comprehensive nursing that aims to restore the body function of patients with myocardial infarction.
To explore the therapeutic effect of cardiac rehabilitation nursing in patients with myocardial infarction.
This was a case-control retrospective study.
This study was conducted in the Department of Heart Center, Shanghai Sixth People's Hospital.
86 patients with acute myocardial infarction admitted to the Heart Center of Shanghai Sixth People's Hospital from January 2019 to August 2022 were selected and randomly divided into observation and control groups, with 43 cases in each group. Patients aged from 40-79 years old and were confirmed to have acute myocardial infarction by examination and histopathological analysis.
The observation group was given cardiac rehabilitation nursing, including psychological nursing, rehabilitation training, cardiac rehabilitation training, diet and defecation care and health education, and the control group was assigned routine nursing.
(1) anxiety and depression were assessed by Zung's self-rating anxiety scale and self-rating depression scale (2) cardiac function was assessed by left ventricular ejection fraction and left ventricular end-diastolic volume (3) 6-minute walk distance (4) incidence of complications (5) length of hospital stay (6) levels of inflammatory factors and N-terminal pro-brain natriuretic peptide concentration (7) incidence of arrhythmia.
After the intervention, there was still no significance in either group's left ventricular end-diastolic volume level [(72.24±8.47) vs (71.98±8.35)] (P = .473). However, the anxiety and depression scores [(42.10±5.17) and (44.01±4.53) vs (44.01±4.53) and (51.37±4.85)], complication rate (6.9% vs 16.2%), length of hospital stay [(18.66±7.03) vs (26.11±8.14)], inflammatory factor levels [(1.95±0.51) and (319.47±33.72) vs (2.71±0.45) and (451.07±39.54)], serum N-terminal pro-brain natriuretic peptide level [(2525.8±1236.5) vs (3064.4±859.0)], and incidence of arrhythmia (3 cases, 2 cases, 1 case and 1 case vs 5 cases, 6 cases, 8 cases and 7 vases) in the observation group were lower compared to the control group (P = .000, P = .002, P=0.023, P = .045, P = .032, P = .011, and P = .027). The left ventricular ejection fraction level and 6-minute walk distance of the observation group [(60.39±5.38) and (347.31±21.01) vs (54.97±6.24) and (320.24±21.71)] were better relative to the control group (P = .037 and P = .000).
For patients with myocardial infarction, the implementation of cardiac rehabilitation nursing can effectively alleviate the anxiety and depression of patients, decrease the incidence of complications as well as inflammatory factors levels, and further shorten the hospital stay of patients, with high safety. Our study provides a clinical reference for patients with myocardial infarction w who need nursing care.
急性心肌梗死是由于冠状动脉急性持续性缺血缺氧所导致的心肌坏死。它可并发心律失常、休克或心力衰竭,常危及生命。该病在欧美最为常见,每年约有150万例心脏病发作。近年来中国呈明显上升趋势,每年新增至少50万例,每年新增至少200万例。心脏康复护理是一种旨在恢复心肌梗死患者身体功能的综合护理。
探讨心脏康复护理对心肌梗死患者的治疗效果。
这是一项病例对照回顾性研究。
本研究在上海第六人民医院心脏中心进行。
选取2019年1月至2022年8月在上海第六人民医院心脏中心住院的86例急性心肌梗死患者,随机分为观察组和对照组,每组43例。患者年龄在40 - 79岁之间,经检查和组织病理学分析确诊为急性心肌梗死。
观察组给予心脏康复护理,包括心理护理、康复训练、心脏康复训练、饮食及排便护理和健康教育,对照组给予常规护理。
(1)采用zung自评焦虑量表和自评抑郁量表评估焦虑和抑郁情况;(2)通过左心室射血分数和左心室舒张末期容积评估心功能;(3)6分钟步行距离;(4)并发症发生率;(5)住院时间;(6)炎症因子水平及N末端脑钠肽前体浓度;(7)心律失常发生率。
干预后,两组左心室舒张末期容积水平仍无差异[(72.24±8.47)与(71.98±8.35)](P = 0.473)。然而,观察组的焦虑和抑郁评分[(42.10±5.17)和(44.01±4.53)与(44.01±4.53)和(51.37±4.85)]、并发症发生率(6.9% 与16.2%)、住院时间[(18.66±7.03)与(26.11±8.14)]、炎症因子水平[(1.95±0.51)和(319.47±33.72)与(2.71±0.45)和(451.07±39.54)]、血清N末端脑钠肽前体水平[(2525.8±1236.5)与(3064.4±859.0)]以及心律失常发生率(3例、2例、1例和1例与5例、6例、8例和7例)均低于对照组(P = 0.000,P = 0.002,P = 0.023,P = 0.045,P = 0.032,P = 0.011,P = 0.027)。观察组的左心室射血分数水平和6分钟步行距离[(60.39±5.38)和(347.31±21.01)与(54.97±6.24)和(320.24±21.71)]相对于对照组更好(P = 0.037和P = .000)。
对于心肌梗死患者,实施心脏康复护理可有效缓解患者焦虑和抑郁情绪,降低并发症发生率及炎症因子水平,进一步缩短患者住院时间,安全性高。本研究为需要护理的心肌梗死患者提供了临床参考。