王琼

【摘要】 目的：探讨冠心病患者行冠状动脉介入（PCI）术后即刻康复护理指导的临床疗效。方法：选取本院心血管内科2017年1月至2018年12月行冠心病PCI术后患者68例，按照PCI手术时间排序将患者随机分为观察组和对照组，每组34例。对照组患者实施PCI术后常规护理和康复指导干预，观察组在对照组的基础上给予即刻康复护理技术指导干预。比较两组患者干预前和干预一周后的心脏射血功能（LVEDD、LVEF）、血浆BNP水平和住院时间。跟踪指导6个月，对比两组患者心脏不良事件发生情况和护理满意度。结果：干预一周，观察组LVEDD、LVEF评分，血浆BNP水平改善情况明显优于对照组，观察组住院时间明显短于对照组;跟踪指导6个月，观察组心脏不良事件发生率明显低于对照组，观察组护理满意度明显高于对照组，差异均有统计学意义（P<0.05）。结论：冠心病患者行PCI术后即刻康复护理指导可有效改善患者的心功能，缩短住院時间，减少心脏不良事件的发生，提高患者满意度。

【关键词】 冠心病;PCI术后;即刻康复;心脏功能;不良事件;满意度

Nursing Guidance and Effect Observation of Immediate Rehabilitation Training for Patients with Coronary Heart Disease After PCI

Wang Qiong

Department of Cardiology， Lianyungang Affiliated Hospital， Nanjing University of Traditional Chinese Medicine， Lianyungang，Jiangsu 222004

[Abstract] Objective：To explore the clinical efficacy of immediate rehabilitation nursing after coronary artery intervention （PCI） in patients with coronary heart disease. Methods：68 patients with coronary heart disease after PCI were enrolled in our Department of Cardiology， from January 2017 to December 2018. The patients were randomly divided into observation group and control group according to the order of PCI operation time， 34 cases in each group. Patients in the control group underwent routine nursing and rehabilitation instruction intervention after PCI， and the observation group was given immediate interventional nursing technical guidance intervention on the basis of the control group. Cardiac ejection function （LVEDD， LVEF）， plasma BNP levels， and length of hospital stay were compared between the two groups before and after one intervention. The followup guidance was 6 months， and the incidence of cardiac adverse events and nursing satisfaction were compared between the two groups. Results：During the intervention week， the improvement of plasma BNP level in the observation group was significantly better than that in the control group. The hospitalization time of the observation group was significantly shorter than that of the control group. After 6 months of followup， the incidence of cardiac adverse events in the observation group was significantly lower than that of the control group. The satisfaction of group nursing was significantly higher than that of the control group， and the difference was statistically significant （P<0.05）. Conclusion：Immediate rehabilitation training after PCI in patients with coronary heart disease can effectively improve the patient's heart function， shorten hospital stay， reduce cardiac adverse events， and improve patient satisfaction.

[Key words]Coronary heart disease; Postoperative PCI; Immediate rehabilitation; Cardiac function; Adverse events; Satisfaction

近20年来，随着国民经济发展，人民生活水平的提高，生活水平也发生了快速的改变，中国心血管病患病率和死亡率处于持续上升阶段[1]。据《中国心血管病报告2017》显示，在2.9亿名心血管病患者中有冠心病患者1100万人，心力衰竭450万人，高血压2.45亿人。2012年以来，中国城市和农村居民冠心病死亡率继续保持上升趋势，急性心梗死亡率呈现快速上升趋势[2]。经皮冠状动脉介入治疗（percutaneous coronary intervention，PCI）是经心导管技术疏通狭窄甚至闭塞的冠状动脉管腔，从而改善心肌的血流灌注。PCI虽然能够快速缓解患者心肌缺血的疼痛症状，但是仍然存在诸如心脏功能进行性下降和再狭窄的问题，术后心脏康复护理对于患者心脏功能恢复和生活质量提升有较大的影响[34]。……