| Since Gruentzig firstly used Percutaneous Transluminal Coronary Angioplasty(PTCA) for the successful treatment of coronary constriction in 1977 , PTCA has become one of the effective methods to treat coronary constriction and improve myocardial ischemia.It has been proved that PTCA has long-term effect on the improvement of heart function postoperatively. But there's little study on the early influence of PTCA on heart function. In China, routine nursing on PTCA patients just covers observation of early postoperative complication. However little importance is attached to nursing which aims at heart function after PTCA and early rehabilitative nursing for the patients. The purpose of this study is to provide theoretic foundation and references to the improvement of perioperative nursing program for PTCA patients by observing related parameters reflecting changes in heart function before and after PTCA, and also by working out early rehabilitative exercise program, directing its implementation and evaluating its effects.Part 1 Analysis of characteristics of changes in Heart Function within a week after PTCA in patients with coronary heart disease.60 cases with successful PTCA and PTCA with stent were selected and divided into 2 groups: group of angina patients and group of myocardial infarction patients. Some electrocardiogram and hemodynamic parameters were measured at given time a day before operation and each day within 7 days after operation, and the changes between them were compared.Results suggested: â‘ There is an significant statistics difference between improvement rate of ischemic ST segment every day after operation (p<0.01), withthe obvious change on 7th day. â‘¡ QT Dispersion and Corrected QT Dispersion measured in two groups before operation were both significantly higher than normal. But compared with a day before operation, they are obviously lower on every postoperative day (p<0.01). On the 1st postoperative day, they were lower than the days before operation, but there's little change of them between 1st day and 3rd day after operation. Not until 5th day after operation, they dropped to normal level. It showed that PTCA could lower QT Dispersion and Corrected QT Dispersion in the patients with angina and myocardial infarction. However it was a gradual process, which suggested they didn't drop to the normal level instantly, but on the 5th day after operation. â‘¢Hemodynamic parameters measured before operation were lower than those after operation to some degree, including SV, CO, CI, SWI, MCF, TPF, LVEF and MVO, with the lowest on 3rd day, and on 5th day or 7th day coming to the normal level. It suggested that heart function within a week after PTCA underwent a process from dropping to recovering. In addition, compared with the days before operation, there were no significant changes in parameters reflecting cardiac diastolic function postoperatively, which suggested that heart diastolic function within a week after PTCA did have little change. Part 2 Influence of Rehabilitative Exercise on the Heart Function of patients with coronary heart disease within a week after PTCA . 44 cases with successful PTCA were research subjects, whom randomly divided into 2 groups using the paired principle according to their ages and number of PTCA: group of routine therapy and group of rehabilitative exercise. Referring by rehabilitative exercises program recommended by American Heart Association (AHA), we made a rehabilitative exercise plan ourselves in accord with our current nursing status. By that, we gave postoperative direction to the patients in group of rehabilitative exercise and supervision for their implementation. Hemodynamic parameters were measured and compared between a day before operation and 1st , 3rd , 5th and 7th day after operation.Results suggested: â‘ Although each hemodynamic parameter in both groups was lower on 1st and 3rd day than a day before operation, there's no significant difference between two groups.â‘¡ On 5th and 7th day after PTCA, CO, MCF and TPF were significa...
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