| Objective: This study aims to explore the effects of postural intervention nursing from different angles on myocardial oxygen consumption,symptoms/ signs,comfort and other outcome indexes of elderly patients with early acute heart failure,in order to provide clinical decision-making reference for nurses to choose the best posture management for elderly patients with acute heart failure.Methods: Taking the elderly patients with early acute heart failure who were treated in the emergency department and cardiovascular department of our hospital from June 2022 to December 2022 as potential research subjects,according to the inclusion criteria,exclusion criteria and sample size calculation formula,select patients who meet the requirements for this study.Considering that there may be 20% sample drop rate in the course of the study,the total number of cases needed in this study was finally determined.129 elderly patients with acute heart failure were randomly divided into three groups: 15 °semi-recumbent position group,30 °semi-recumbent position group and 60 °semi-recumbent position group,with 43 cases in each group.The measured values of each index of patients in each group after self-comfort position 30 min were taken as the basic value of observation and comparison.The head of the multi-functional medical bed was controlled by nurses to raise to the target angle,and the digital display multi-purpose angle ruler was used to measure to ensure that the target value was reached.The time points of observation were basic time(T1),postural 30min(T2),postural60min(T3),postural 90min(T4)and postural 120min(T5).The changes of cardiac function related indexes(including heart rate,systolic blood pressure,diastolic blood pressure,myocardial oxygen consumption),respiratory related indexes(including dyspnea score,respiratory rate)in each group were observed before and after nursing intervention at different angles,and compared before and after intervention and between groups.Results:1.Heart rate,systolic blood pressure,diastolic blood pressure,and myocardial oxygen consumption at T2,T3,T4,and T5 were close to those of T1,and there was no obvious trend of change(P>0.05).2.There were significant differences in systolic blood pressure at T2,T3,T4,and T5 in patients with 30° semi-recumbent position(P<0.05),and there were certain differences in heart rate and myocardial oxygen consumption at different time points compared with T1(P<0.05).3.There are significant differences in the heart rate of patients in the 60°semi-recumbent position at T2,T3,T4,and T5(P<0.05).Among them,there were certain differences in heart rate,systolic blood pressure,diastolic blood pressure and myocardial oxygen consumption at sometimes compared with T1(P<0.05).4.At T1,there were significant differences in heart rate and systolic blood pressure among the groups(P<0.05),but there was no significant difference in diastolic blood pressure and myocardial oxygen consumption among the groups(P>0.05).5.At T5,the dyspnea VAS score and respiratory rate of patients in each group were significantly lower than those at T1(P<0.05),and the reduction was more significant in patients with 30° semi-recumbent position and 60°semi-recumbent position(P<0.05).6.There were differences in physiological comfort,psychological comfort,sociocultural comfort,environmental comfort and overall comfort scores after intervention position,among which 30 semi-lying patients and 60semi-lying patients had higher satisfaction(P <0.05).Conclusion: Nursing care in 30° semi-recumbent position and60 °semi-recumbent position can affect the clinical heart rate,systolic blood pressure,diastolic blood pressure and myocardial oxygen consumption of elderly patients with early AHF,which may lead to improvement of clinical symptoms and signs such as dyspnea,abnormal respiratory rate in varying degrees.At the same time,it can effectively improve patients’ satisfaction in the process of treatment and nursing. |
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