| Background:Coronary heart disease is one of the most important causes of death and disease burden worldwide.Among them,acute myocardial infarction causes acute onset,high mortality,and poor prognosis.It has become the leading cause of death among coronary heart disease.Percutaneous coronary intervention is one of the most important ways of revascularization in patients with acute myocardial infarction.It can quickly open criminal blood vessels and save more surviving myocardium.However,surgery and drugs cannot continuously and effectively improve the prognosis of patients.Early cardiac rehabilitation with exercise as the core has definite benefits in reducing cardiovascular disease mortality and improving patient prognosis and quality of life.It has become an important adjuvant treatment method for patients after PCI technique in developed countries.Cardiac rehabilitation in China is still in its infancy.At present,there is no unified standard for early cardiac rehabilitation nursing procedures for patients after emergency PCI.There is no specific nursing operation plan for when to start rehabilitation,what kind of rehabilitation and how to proceed.Therefore,It is imminent to build a practice plan for early cardiac rehabilitation nursing after emergency PCI operation,and to promote early cardiac rehabilitation nursing concepts and models.Objective:Establish an early(7 days)cardiac rehabilitation nursing practice plan in CCU for acute myocardial infarction emergency PCI operation,explore the feasibility of early cardiac rehabilitation nursing practice plan and verify the clinical effect.Provide a basis for the promotion and evaluation system of early cardiac rehabilitation nursing mode for patients with acute myocardial infarction emergency PCI after domestic emergency.Methods:This study first conducted a meta-analysis of the effects of early rehabilitation activities on patients undergoing PCI after AMI emergency treatment,sorted out rehabilitation programs,and clarified clinical effect evaluation indicators.Then on the basis of literature review,discussion of the guidance group for program development,and Delphi expert consultation,an early cardiac rehabilitation nursing practice program for acute myocardial infarction after emergency PCI was formed.From June 2019 to December 2019,76 patients with acute myocardial infarction undergoing emergency PCI from radial artery pathway were selected in a cardiac intensive care unit(ccu)of a top three cardiovascular specialist hospital in Beijing.Random number table method was used to divide them into intervention group and control group,38 cases in each group.Results:1.Through consultation with 16 domestic experts,early cardiac rehabilitation nursing practice program for patients after emergency PCI.The contents of the program include 56 items of 5 first-level indicators including sports rehabilitation,advanced rehabilitation methods,health education,daily life guidance,and energy consumption.2.There were no significant difference in demographic data and clinical disease-related data between the two groups of patients(P>0.05).3.There were no statistically significant difference in baseline cardiac function data between the two groups,and they were comparable(P>0.05).After early rehabilitation nursing intervention,the cardiac function indexes of LVEF,LVED,CO,SV between the two groups of patients were not statistically significant.4.There were no significant difference in the results of grip strength test between the two groups before intervention(P>0.05).After early rehabilitation nursing intervention,there were no differences in grip strength between the two groups of patients(P>0.05).The difference between the baseline level of the two groups of patients and the grip strength test before discharge was statistically significant(P<0.05).5.There were no significant difference in the quality of life score between the two groups of patients before intervention(P>0.05).One month after discharge from the hospital,the scores of the physiological function,physiological function,general health status and social function dimension of the intervention group were higher than those of the control group.The difference was statistically significant(P<0.05).One month after discharge,the physiological function score of the intervention group was(93.97±4.33)and the control group was(88.68 ± 8.19);the physiological function score of the intervention group was(80.92 ± 15.85)and the control group was(71.05 ± 17.94);The general health score of the intervention group was(81.47±11.03)and the control group was(76.74±7.90);the social function score of the intervention group was(90.79±9.04)and the control group was(86.51±9.36).6.The difference in hospital stay between the two groups was not statistically significant(P>0.05).The hospital stay of the intervention group was(4.79 ± 1.77)days,and the control group was(5.45 ± 1.87)days.7.The activity level of patients in the intervention group before discharge from the ccu was higher than that of the control group,the difference was statistically significant(P<0.05).8.The patients in the intervention group had no adverse cardiac events 1 month after discharge from the hospital,and one patient in the control group had angina.Conclusion:1.Early cardiac rehabilitation nursing practice program is safe and feasible for patients with acute myocardial infarction after emergency PCI.2.Patients with acute myocardial infarction who have no serious complications after PCI surgery can start cardiac rehabilitation care after returning to the ward,and can get out of bed within 12h-72h after surgery.3.Early cardiac rehabilitation nursing can significantly improve the patient’s mobility after acute PCI after acute myocardial infarction,improve the patient’s quality of life,and do not increase the incidence of cardiac events.4.Early cardiac rehabilitation nursing may improve cardiac function and muscle strength to a certain extent after emergency PCI for acute myocardial infarction. |
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