中华护理杂志 ›› 2020, Vol. 55 ›› Issue (10): 1571-1577.DOI: 10.3761/j.issn.0254-1769.2020.10.023
收稿日期:
2019-10-08
出版日期:
2020-10-15
发布日期:
2020-09-27
通讯作者:
李庆印
作者简介:
谷雨擎:女,本科(硕士在读),E-mail: <email>641011263@qq.com</email>
基金资助:
GU Yuqing(),LI Qingyin(),WU Jie,LIU Yuwen
Received:
2019-10-08
Online:
2020-10-15
Published:
2020-09-27
Contact:
Qingyin LI
摘要:
目的 对急性心肌梗死患者经皮冠状动脉介入治疗后早期下床活动的效果进行评价。 方法 检索PubMed、EMbase、Cochrane Library、CINAHL、中国生物医学文献数据库、中国知网和万方数据库中对急性心肌梗死PCI术后患者进行早期下床活动干预的临床随机对照试验,采用Cochrane系统评价手册对文献质量进行评价,采用RevMan 5.3进行Meta分析。 结果 共纳入8篇临床随机对照试验,总样本量586例,文献质量评价等级A级为5篇,B级为3篇。Meta分析结果显示,与对照组相比,试验组左心室射血分数[MD=5.75,95%CI(4.52,6.99),P<0.001]高于对照组,但出院前两组6 min步行距离的比较,差异无统计学意义;总住院时间明显缩短[MD=-3.84,95%CI(-6.65,-1.02),P=0.008];试验组术后心脏不良事件发生率[RR=0.44,95%CI(0.25,0.75),P=0.003]低于对照组,生活质量明显改善。 结论 早期下床有利于急性心肌梗死患者心肺功能的恢复,减少住院时间,有效防止心脏不良事件的发生,改善患者生活质量。
谷雨擎, 李庆印, 武杰, 刘裕文. 急性心肌梗死患者经皮冠状动脉介入治疗后早期下床活动效果的系统评价[J]. 中华护理杂志, 2020, 55(10): 1571-1577.
GU Yuqing, LI Qingyin, WU Jie, LIU Yuwen. The effects of early ambulation in patients with acute myocardial infarction after emergency PCI:a systematic review[J]. Chinese Journal of Nursing, 2020, 55(10): 1571-1577.
[1] | 国家心血管病中心. 中国心血管病报告-2018,2018[M]. 北京: 中国大百科全书出版社, 2019. |
National Center for Cardiovascular Diseases. China cardiovas-cular disease report-2018,2018[M]. Beijing: Encyclopedia of China Publishing House, 2019. | |
[2] | 陈纪言, 陈韵岱, 韩雅玲, 等. 经皮冠状动脉介入术后运动康复专家共识[J]. 中国介入心脏病学杂志, 2016,24(7):361-369. |
Chen JY, Chen YD, Han YL, et al. Expert consensus on exercise rehabilitation after percutaneous coronary intervention[J]. Chin J Interv Cardio, 2016,24(7):361-369. | |
[3] | 杜若飞, 王盼盼, 田丽, 等. 冠心病患者心脏康复依从性的研究进展[J]. 中华护理杂志, 2017,52(10):1246-1251. |
Du RF, Wang PP, Tian L, et al. Research progress on comp-liance of cardiac rehabilitation in patients with coronary heart disease[J]. Chin J Nurs, 2017,52(10):1246-1251. | |
[4] |
Cortés OL, DiCenso A, McKelvie R. DiCenso A,McKelvie R. Mobilization patterns of patients after an acute myocardial infarction:a pilot study[J]. Clin Nurs Res, 2015,24(2):139-155.
DOI URL PMID |
[5] | Goel K, Lennon RJ, Tilbury RT, et al. Impact of cardiac reha-bilitation on mortality and cardiovascular events after per-cutaneous coronary intervention in the community[J]. Circula-tion, 2011,123(21):2344-2352. |
[6] | Magalhães S, Miguel Ribeiro M, Barreira A, et al. Long-term effects of a cardiac rehabilitation program in the control of cardiovascular risk factors[J]. Revista Portuguesa De Cardiol Engl Ed, 2013,32(3):191-199. |
[7] |
Shepherd CW, While AE. Cardiac rehabilitation and quality of life:a systematic review[J]. Int J Nurs Stud, 2012,49(6):755-771.
DOI URL |
[8] | 日本循环器学会. 心血管疾患におけるリハヒ?リテーションに関するカ?イト?ライン( 2012年改訂版)[Z]. 2015. |
[9] |
Ibanez B, James S, Agewall S, et al. 2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation:the task force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology(ESC)[J]. Eur Heart J, 2018,39(2):119-177.
DOI URL PMID |
[10] |
de Macedo RM, Faria-Neto JR, Costantini CO, et al. Phase I of cardiac rehabilitation:a new challenge for evidence based physiotherapy[J]. World J Cardiol, 2011,3(7):248-255.
DOI URL PMID |
[11] |
Cortes OL, Villar JC, Devereaux PJ, et al. Early mobilisation for patients following acute myocardiac infarction:a systematic review and meta-analysis of experimental studies[J]. Int J Nurs Stud, 2009,46(11):1496-1504.
DOI URL |
[12] | Higgins JP, Green S. Cochrane handbook for systematic reviews of interventions[M]. Chichester,UK:John Wiley & Sons,Ltd, 2008. |
[13] | 渠林楠, 崔玉芳, 虞彬. 早期康复对经桡动脉行急诊PCI的急性心梗患者左室射血分数及运动耐量的影响[J]. 实用临床医药杂志, 2017,21(8):5-7. |
Qu LN, Cui YF, Yu B. Effect of early rehabilitation on left ventricular ejection fraction and exercise tolerance in patients with acute myocardial infarction treated by radial artery PCI[J]. J Clin Med Pract, 2017,21(8):5-7. | |
[14] | 刘瑞云, 刘飞. 急性心肌梗死患者急诊行经皮冠状动脉介入术后早期康复治疗对心脏射血分数的影响[J]. 首都食品与医药, 2018,25(20):33. |
Liu RY, Liu F. The effect of early rehabilitation after per-cutaneous coronary intervention in patients with acute myo-cardial infarction on cardiac ejection fraction[J]. Capital Food Medicine, 2018,25(20):33. | |
[15] | 席小红, 沈霖, 丁小娟. 身心综合护理对急性心肌梗死并左心衰竭患者经皮冠状动脉介入治疗后负性情绪及心功能的影响[J]. 实用心脑肺血管病杂志, 2019,27(4):107-110. |
Xi XH, Shen L, Ding XJ. Impact of psychosomatic compre-hensive nursing care on negative emotion and cardiac function in postoperative acute myocardial infarction patients complicated with left heart failure treated by PCI[J]. Pract J Cardiac Cereb Pneum Vasc Dis, 2019,27(4):107-110. | |
[16] | 马玉平, 黄国莹. 早期康复运动训练对急性心肌梗死PCI术后患者康复效果的影响[J]. 中国保健营养, 2016,5:291. |
Ma YP, Huang GY. The effect of early rehabilitation exercise training on the rehabilitation effect of patients with acute myocardial infarction after PCI[J]. Chin Health Care Nutri, 2016,5:291. | |
[17] | 张巍, 施志芸, 王正龙. 早期心脏康复计划对非ST段抬高心肌梗死患者PCI术后心功能及终点事件的影响[J]. 辽宁医学杂志, 2018,32(5):23-26. |
Zhang W, Shi ZY, Wang ZL. Effect of early cardiac reha-bilitation program on cardiac function and end-point events in patients with non-ST-segment elevation myocardial infarction after PCI[J]. Med J Liaoning, 2018,32(5):23-26. | |
[18] | 陈丽娜, 段培蓓, 张学萍. 早期心脏康复计划对急性心肌梗死PCI术后生活质量的影响[J]. 中西医结合护理(中英文), 2017,3(2):89-91. |
Chen LN, Duan PB, Zhang XP. Effects of early cardiac reha-bilitation program on the quality of life after PCI in acute myocardial infarction[J]. Nurs Integ Trad Chin West Med(Chinese and English), 2017,3(2):89-91. | |
[19] | 胡靖, 杨雪佳, 谢红梅. 早期心脏康复计划对急性心肌梗死PCI术后生活质量的影响[J]. 医学食疗与健康, 2019(3):137. |
Hu J, Yang XJ, Xie HM. The effect of early cardiac reha-bilitation program on the quality of life after PCI after acute myocardial infarction[J]. Med Diet Heal, 2019(3):137. | |
[20] | Mohammad RA, Hasanali J, Mohsen S, et al. Effects of early mobilization program on the frequency of pain and duration of hospitalization of patients with myocardial infarction[J]. Advances in Environmental Biology, 2015,9(3):275-280 . |
[21] | Firoozeh A, Maryam T, Kaynoosh H, et al. The assessment of cardiac rehabilitation on echocardiographic parameters of left ventricular systolic function in patients treated by primary percutaneous coronary intervention due to acute ST-segment elevation myocardial infarction:a randomized clinical trial[J]. Int Cardiovasc Res, 2017,11(4):130-136. |
[22] |
Tsai YJ, Li MH, Chen CH, et al. Improved oxygen uptake effi-ciency slope in acute myocardial infarction patients after early phase I cardiac rehabilitation[J]. Int J Rehabil Res, 2017,40(3):215-219.
DOI URL PMID |
[23] |
Routledge FS, Campbell TS, McFetridge-Durdle JA, et al. Im-provements in heart rate variability with exercise therapy[J]. Can J Cardiol, 2010,26(6):303-312.
DOI URL |
[24] |
Santos-Hiss MD, Melo RC, Neves VR, et al. Effects of progre-ssive exercise during phase I cardiac rehabilitation on the heart rate variability of patients with acute myocardial infarction[J]. Disabil Rehabil, 2011,33(10):835-842.
DOI URL |
[25] | 蹇祥玉, 路海云, 罗莹怡, 等. 急性ST段抬高型心肌梗死患者急诊PCI术后I期心脏康复护理研究[J]. 护理学杂志, 2016,31(23):1-4. |
Jian XY, Lu HY, Luo YY, et al. Study on the phase I cardiac rehabilitation nursing for acute ST-segment elevation myo-cardial infarction patients after emergency PCI[J]. J Nurs Sci, 2016,31(23):1-4. | |
[26] | 顾淑芳, 于艳艳, 张丽敏. 急性心肌梗死患者行冠状动脉介入术后即刻康复训练的效果研究[J]. 中华护理杂志, 2018,53(2):173-178. |
Gu SF, Yu YY, Zhang LM. Effects of immediate exercise training after radial artery coronary intervention in patients with acute myocardial infarction[J]. Chin J Nurs, 2018,53(2):173-178. | |
[27] |
Peixoto TC, Begot I, Bolzan DW, et al. Early exercise-based rehabilitation improves health-related quality of life and functional capacity after acute myocardial infarction:a randomized controlled trial[J]. Can J Cardiol, 2015,31(3):308-313.
DOI URL PMID |
[28] | 詹秀珠, 胡征芬, 巢毅, 等. 急性心梗两周康复程序的疗效观察及分析[J]. 心血管康复医学杂志, 2010,19(4):356-358. |
Zhan XZ, Hu ZF, Chao Y, et al. Impact of two-week rehabi-litation program on exercise capacity,heart function and psy-chological state in patients with acute myocardial infarction[J]. Chin J Cardi Reh Med, 2010,19(4):356-358. | |
[29] | 赵艳, 王禹. 康复运动与冠状动脉支架置入血管后再狭窄[J]. 中国组织工程研究与临床康复, 2010,14(17):3181-3184. |
Zhao Y, Wang Y. Rehabilitation exercise and restenosis follow-ing coronary implantation[J]. J Clin Reh Tis Engin Res, 2010,14(17):3181-3184. | |
[30] | 马云飞, 王洪娟, 王俊峰, 等. 急性心肌梗死患者PCI术后的心脏康复现状及进展[J]. 中国老年学杂志, 2017,37(7):1778-1779. |
Ma YF, Wang HJ, Wang JF, et al. The status and progress of cardiac rehabilitation in patients with acute myocardial infar-ction after PCI[J]. Chin J Geron, 2017,37(7):1778-1779. | |
[31] | 冯舒爽, 华俊, 魏睿宏, 等. 改良早期心脏康复方案在经皮冠状动脉介入术后患者中的应用[J]. 中华护理杂志, 2020,55(9):1330-1334. |
Feng SS, Hua J, Wei RH, et al. Application of a modified version of early cardiac rehabilitation program in patients with acute ST-segment elevation myocardial infarction treated by percutaneous coronary intervention[J]. Chin J Nurs, 2020,55(9):1330-1334. | |
[32] | 郝云霞, 周政, 刘庆荣, 等. 从心血管专科发展看护理在心脏康复中的作用[J]. 中华护理杂志, 2015,50(6):645-649. |
Hao YX, Zhou Z, Liu QR, et al. The role of nursing care in cardiac rehabilitation in developing cardiovascular treatment[J]. Chin J Nurs, 2015,50(6):645-649. |
[1] | 郝瑞霞, 李育玲, 徐勇, 杨丽洁, 韩雪. 冠心病患者负性情绪智能化改善方案的制订及应用[J]. 中华护理杂志, 2021, 56(9): 1285-1292. |
[2] | 张继文, 范环, 肖树芹, 杨芳宇, 吴瑛. 独居与非独居老年人居家照护未满足需求的比较研究[J]. 中华护理杂志, 2021, 56(9): 1293-1298. |
[3] | 陆金玲, 许勤, 陈丽, 丁玲玉, 花红霞, 徐欣怡. 5种肌肉减少症筛查工具在胃癌患者术前营养评定中的应用比较[J]. 中华护理杂志, 2021, 56(9): 1299-1304. |
[4] | 燕美琴, 王娇, 刘亦娜, 张慧君, 任永莲. 群组孕期保健模式在妊娠期糖尿病孕妇分娩结局中的效果研究[J]. 中华护理杂志, 2021, 56(9): 1305-1311. |
[5] | 黄娜, 周英凤, 李丽, 刘巧艳, 朱佳蕾, 汪玲, 潘秀红, 郭娜菲. 妊娠期糖尿病孕妇血糖管理决策行为及影响因素的研究[J]. 中华护理杂志, 2021, 56(9): 1312-1317. |
[6] | 朱淑榕, 魏碧蓉, 郭胜斌, 林颖. 硬膜外分娩镇痛产妇护理支持需求问卷的研制及信效度检验[J]. 中华护理杂志, 2021, 56(9): 1318-1324. |
[7] | 蒋阳, 沈鸣雁, 冯志仙. 1例镜像综合征并发急性心力衰竭孕妇的护理[J]. 中华护理杂志, 2021, 56(9): 1325-1328. |
[8] | 申乔乔, 冯现刚, 梁韵仪, 左倩倩, 张正敏, 高钰琳. 围产期哀伤辅导指南的系统评价[J]. 中华护理杂志, 2021, 56(9): 1329-1334. |
[9] | 金微, 肖琦, 杨凌艳, 曾铁英. 紧急剖宫产术后产妇心理健康问题的研究进展[J]. 中华护理杂志, 2021, 56(9): 1335-1339. |
[10] | 曹亚雨, 刘惠蓉, 彭玉娇, 杨权, 杨思锐, 陶彦灵, 温贤秀. 肾移植受者手术决策参与满意度的调查研究[J]. 中华护理杂志, 2021, 56(9): 1340-1345. |
[11] | 齐晓玖, 王慧婷, 刘宇, 杨晶, 乔红梅, 田家利, 唐丽安, 张素. 临床护士对氧疗安全认知的现状调查[J]. 中华护理杂志, 2021, 56(9): 1346-1351. |
[12] | 孙文静, 谢莉玲, 黄龙贤, 游海玲, 屈芙蓉, 左燕. 鼻饲患者两种误吸风险预测模型的外部验证及比较[J]. 中华护理杂志, 2021, 56(9): 1352-1356. |
[13] | 陈虹秀, 杨莘, 胡秀英, 邓宝凤, 马红梅, 张艾灵, 方海云, 石泽亚, 丁福, 王传霞, 亓恒美, 黄沂, 张俊梅, 马秀花, 鲁丽萍, 王申, 沙丽艳, 曹军华. 我国30个省份老年专科护士队伍培养与工作现状调查研究[J]. 中华护理杂志, 2021, 56(9): 1363-1368. |
[14] | 王雪瑞, 陈雁, 王清, 夏冬云, 许玲. 基于服务质量差距模型的“互联网+护理服务”质量评价指标研究[J]. 中华护理杂志, 2021, 56(9): 1369-1376. |
[15] | 郑丽丽, 吕丹尼, 唐晓敏, 陈丽骊, 张婷, 傅藏藏, 诸纪华, 汪金燕. 3例先天性长段缺失型食管闭锁患儿行胃造瘘术的术后护理[J]. 中华护理杂志, 2021, 56(9): 1377-1379. |
阅读次数 | ||||||
全文 |
|
|||||
摘要 |
|
|||||