| Objective:The purpose of this study is to explore the intervention methods after coronary artery bypass grafting in early 3 days after operation,the joint function exercise effect on the rehabilitation of limb function of lower extremity vascular bridge,in order to reduce limb swelling and incision complications,shorten the postoperative ambulation time,shorten the hospitalization time after operation.Materials and Methods:With the convenient sampling principle,selected from February 2017 to September in the first hospital of Nanjing City cardiothoracic surgery CABG patients as the research object,using the coin toss method will meet the inclusion and exclusion criteria were randomly divided into control group and experimental group,45 cases in each group,the clinical data of two groups of patients more than baseline.The rehabilitation nursing group was established after the operation,the control group was given routine postoperative care,observation of disease;compliance with anticoagulation,prevention of thrombosis;postoperative limb elevation,elastic bandage;guiding patients with abdominal breathing,cough,expectoration,given aerosol inhalation,prevention of pulmonary complications,strengthen kidney function monitoring;diet guidance.On the basis of routine nursing,the experimental group performed early joint functional exercise(foot and back flexion,ring movement combined with straight leg lifting movement).The evaluation indicators include: Main Indicators: three days after the operation,tumidness changes,vascular complications,incision of limb bridge after third days of vascular bridge muscle strength rating;secondary index: third days after operation the vessel bridge limb comfort score,postoperative hospitalization time for the first time out of bed activity time,postoperative.Results:There was no significant difference in baseline clinical data between the two groups(P>0.05).(1)The limb swelling after CABG : the swelling rates of thigh、shank and ankel were 57.8%,66.7%,87.8%respectively;the number of thigh、shank and ankel swelling in test group were 20,25,35 cases;32,35 and 43 cases in the control group,there was a significant difference between the two groups(t=6.55、5.00、8.38,P<0.05),and the relief of limb swelling of test group after surgery was superior to that of the control group.(P<0.01);(2)the incidence of limb incision complications were 24 cases(26.7%),with 6 cases in test group and 18 cases in the control group,there was a significant difference between the two groups(t=11.79,P < 0.01)).(3)The limb muscle strength grade(Lovett): the Lovett rating was 3~5 grade overall;in the test group,there were 0 cases of grade 4,19 cases in grade 4,26 cases in grade 5;in the control group,there were 9 cases of grade 3,grade 4 in 26 cases in grade 4;10 cases in grade 5,the difference was statistically significant(2=17.20,P < 0.05).(4)The limb comfort score: the test group is 7.11 + 1.15 and 5.18 + 1.13 in control group,the difference was statistically significant(P<0.000);(5)the postoperative bed time:the test group is 5.28 + 1.07 d and 6.97 + 1.21 d in the control group,there was significant difference between two groups(P<0.000);(6)the time of hospitalization after the operation:the test group is 11.04 + 2.01 d and 12.67 + 1.59 d in the control group,there was significant difference between two groups(P<0.000).Conclusion:This study shows that early combined with functional exercise can effectively reduce coronary artery bypass grafts take limb swelling incidence,severity of lower limb swelling;also can effectively reduce the incidence of incision complications,promote limb muscle recovery,shorten postoperative bed time and postoperative hospitalization time.Therefore,to carry out coronary artery bypass grafting for the early joint functional exercise of the lower limbs of the vascular bridge is worth promoting in the clinical nursing work. |
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