Abstract: Objective To develop a four-stage early rehabilitation program in patients with acute heart failure in compensatory period and evaluate its effects,so as to provide references for their early rehabilitation activities. Methods A research team of early rehabilitation program was established,and a four-stage early rehabilitation program for patients with acute heart failure was initially formulated after literature retrieval and semi-structured interviews. The final plan was formed after the expert panel evaluation. A total of 200 patients with acute heart failure admitted to CCU from April 2017 to June 2019 were recruited by convenient sampling method with 100 patients in the control group and 100 patients in the experimental group. The control group received the regular activity plan,while the experimental group was provided with the four-stage early rehabilitation program. The Minnesota Quality of Life Scale,the 6 min walking test,the average length of hospitalization,the forced expiratory volume in one second （FEV_l）,and the brain natriuretic peptide（BNP） were adopted as monitoring indicators. Results The Minnesota quality of life in the experimental group scored（52.64±5.60） points,which was lower than（56.89±6.59） points（t=-4.877,P< 0.001） in the control group. The distance of 6 min walking test group was（279.86±84.66） m and it was better than（248.78±93.73）m（t=2.441,P=0.016） in the control group. The average length of CCU hospitalization in the experimental group was（8.97±2.80） d,which was less than（10.48±3.80） d（t=-3.182,P=0.002） in the control group. The FEV_l in the experimental group was（2.18±0.49） L,which was higher than（1.92±0.35） L（t=4.338,P< 0.001） in the control group. The BNP level in the experimental group was（697.88±135.58） pg/ml which was smaller than（755.29±141.74） pg/ml（t=-2.905,P=0.004） in the control group. Conclusion The four-stage early rehabilitation program can formulate an individualized activity strategy based on patients' heart function,and guarantee the safety of early activities through team management methods,which can effectively improve the quality of life of patients with acute heart failure,promote the rapid rehabilitation of cardiopulmonary function,and shorten hospitalization time.

Key words: Acute Heart Failure, Early Activity, Early Rehabilitation Nursing, Quality of Life

摘要： 目的 构建急性心力衰竭代偿期患者四阶梯式早期康复活动方案并评价其效果,以期为急性心力衰竭代偿期患者开展早期康复活动提供参考。方法 成立早期康复活动研究团队、在文献检索及半结构化访谈后形成急性心力衰竭代偿期患者四阶梯式早期康复活动的初步方案,经过专家论证后形成最终方案。采用方便抽样法选择2017年4月—2019年6月在北京市某三级甲等医院CCU住院的急性心力衰竭代偿期患者200例为研究对象,试验组与对照组各100例,试验组采用四阶梯式早期康复活动方案,对照组采用常规活动方案。采用明尼苏达生活质量量表、6 min步行试验、住院时间、第1秒用力呼气量、脑利纳肽水平等作为监测指标。结果 试验组明尼苏达生活质量得分（52.64±5.60）分,低于对照组（56.89±6.59）分（t=-4.877,P< 0.001）;试验组6 min步行试验距离（279.86±84.66） m,优于对照组（248.78±93.73） m（t=2.441,P=0.016）;试验组CCU住院时间（8.97±2.80） d,少于对照组（10.48±3.80） d（t=-3.182,P=0.002）;试验组第1秒用力呼气量（2.18±0.49） L,高于对照组（1.92±0.35） L（t=4.338,P< 0.001）;试验组脑利纳肽水平（697.88±135.58） pg/ml,低于对照组（755.29±141.74） pg/ml（t=-2.905,P=0.004）。结论 四阶梯式早期康复活动方案根据患者的心功能制订了个体化的活动策略,通过团队管理的手段保障其早期活动的安全性,能够切实提高急性心力衰竭患者的生活质量、促进患者心肺功能的快速康复、缩短住院时间。

关键词: 急性心力衰竭, 早期活动, 早期康复护理, 生活质量