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急性心肌梗死后早期活动的可行性

Feasibility of early mobilization after acute myocardial infarction.

作者信息

Niemelä K, Takkunen J T, Juustila H, Jounela A J, Palatsi I, Kaipainen W J

出版信息

Ann Clin Res. 1978 Dec;10(6):328-33.

PMID:742833
Abstract

The purpose of the study was to determine the proportion of patients with acute myocardial infarction (AMI) for whom an early programme of mobilization, independent of sex and age was possible, and the main reasons for delay of mobilization. Mobilization according to the programme (sitting on day 2 and standing on day 3) succeeded for 49% of the 241 patients alive and conscious after the 1st day, and there were no significant difference with regard to age and sex. The main reasons for delayed mobilization were prolonged chest pain, conduction disturbances and pulmonary oedema. Discharge on day 10 was feasible for 58% of the 241 patients alive and conscious after the 1st day. The mean hospital stay of the patients discharged later than that was 17.3 days. The reasons for the delayed discharge were delayed mobilization, chest pain persisting while in the ward, reinfarction, social, and other reasons. Early programmed mobilization was thus feasible for almost half the patients, and mobilization had been started in over 90% of the patients by the 5th day. Nevertheless, the remarkably high proportion of readmissions (13.3% of all discharged patients) and reinfarctions (6.9%) within the 30 days following discharge may indicate disadvantages in the early mobilization of some patients.

摘要

该研究的目的是确定急性心肌梗死(AMI)患者中能够实施早期活动计划(与性别和年龄无关)的患者比例,以及活动延迟的主要原因。按照计划进行活动(第2天坐起,第3天站立)在第1天后存活且清醒的241例患者中有49%取得成功,在年龄和性别方面无显著差异。活动延迟的主要原因是胸痛持续时间延长、传导障碍和肺水肿。对于第1天后存活且清醒的241例患者中的58%而言,第10天出院是可行的。晚于该时间出院的患者平均住院时间为17.3天。延迟出院的原因包括活动延迟、在病房时胸痛持续、再梗死、社会因素及其他原因。因此,早期计划活动对几乎一半的患者是可行的,并且到第5天时超过90%的患者已开始活动。然而,出院后30天内再入院率(占所有出院患者的13.3%)和再梗死率(6.9%)非常高,这可能表明早期活动对某些患者存在不利之处。

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