Impact of exercise endurance detail care on postoperative cardiac function and complications in patients with acute myocardial infarction

doi:10.3760/cma.j.issn.1007-1245.2024.14.008

Abstract

Abstract:

Objective　To explore the effects of exercise endurance detail care on postoperative cardiac function and complications in patients with acute myocardial infarction (AMI). Methods　A prospective study design was used, involving 98 AMI patients admitted to Xi'an First Hospital from January 2021 to July 2023. The patients were stratified and randomly assigned into an intervention group and a control group, with 49 patients in each group. In the intervention group, there were 29 males and 20 females, aged (58.34±6.25) years, 26 cases of anterior wall infarction and 23 cases of inferior wall infarction. In the control group, there were 30 males and 19 females, aged (57.89±6.51) years, 25 cases of anterior wall infarction and 24 cases of inferior wall infarction. The control group received routine care, while the intervention group received exercise endurance detail care for 3 months. The cardiac function indicators [left ventricular end-diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF)], 6-minute walk distance (6MWD), scores from the Chinese version of Positive and Negative Affect Schedule (PANAS), Somatization Symptom Scale (SSS), and Seattle Angina Questionnaire (SAQ), and occurrence of complications (arrhythmia, heart failure, stress injury, and venous thrombosis) were compared between the two groups. t test and χ² test were used for statistical analysis. Results　After intervention, the LVEF and 6MWD in the intervention group were (53.83±5.34)% and (408.27±61.49) m, which were higher than those in the control group [(49.87±5.62)% and (375.68±54.62) m], and the LVEDD was (48.34±5.27) mm, which was lower than that in the control group [(51.23±5.24) mm], with statistically significant differences (t=3.576, 2.722, and 2.774, all P<0.05). After intervention, the positive affect (PA) score of the PANAS of the intervention group was (37.61±1.39) points, which was higher than that of the control group [(35.43±1.41) points], the negative affect (NA) score was (15.41±1.27) points, which was lower than that of the control group [(17.47±1.40) points], and the SSS score of the intervention group was (28.16±7.74) points, which was lower than that of the control group [(32.98±9.04) points], with statistically significant differences (t=7.707, 7.629, and 2.835, all P<0.05). After intervention, the scores of angina pectoris attack, angina stability, disease cognition, and efficacy satisfaction of the SAQ in the intervention group were (89.27±9.29), (82.93±9.35), (75.24±8.38), and (81.05±8.15) points, which were higher than those in the control group [(83.68±9.07), (77.67±8.86), (70.85±8.21), and (76.36±7.73) points], with statistically significant differences (t=3.014, 2.858, 2.619, and 2.923, all P<0.05). The total complication rate of the intervention group was 4.08% (2/49), which was lower than that of the control group [18.37% (9/49)], with a statistically significant difference (χ²=5.018, P=0.025). Conclusion　Exercise endurance detail care significantly improved the postoperative cardiac function indicators, reduced the somatic symptoms and angina symptoms, improved the emotional state, and effectively reduced the occurrence of complications in AMI patients, demonstrating its significant clinical value.

Key words:

Acute myocardial infarction, Exercise endurance detail care, Cardiac function, Positive and negative emotions, Complications

摘要：

目的　探究运动耐力细节护理对急性心肌梗死（acute myocardial infarction，AMI）患者术后心功能及并发症的影响。方法　选取2021年1月至2023年7月西安市第一医院收治的98例AMI患者，通过分层随机抽样法分为干预组和对照组，每组49例。干预组男性29例，女性20例，年龄（58.34±6.25）岁，梗死部位：前壁梗死26例，下壁梗死23例。对照组男性30例，女性19例，年龄（57.89±6.51）岁，梗死部位：前壁梗死25例，下壁梗死24例。对照组接受常规护理，干预组接受运动耐力细节护理。干预周期为3个月。比较两组心功能指标［左心室舒张末期内径（left ventricular end-diastolic diameter，LVEDD）、左心室射血分数（left ventricular ejection fraction，LVEF）］、6 min步行距离（6-minute walk distance，6MWD）、中文版正性负性情绪量表（Positive and Negative Affect Schedule，PANAS）评分、躯体化症状自评量表（Somatization Symptom Scale，SSS）评分、西雅图心绞痛量表（Seattle Angina Questionnaire，SAQ）评分和并发症（心律失常、心力衰竭、压力性损伤、静脉血栓形成）的发生状况。统计学方法使用t检验、χ²检验。结果　干预后，干预组LVEF、6MWD为（53.83±5.34）%、（408.27±61.49）m，高于对照组（49.87±5.62）%、（375.68±54.62）m，LVEDD为（48.34±5.27）mm，低于对照组（51.23±5.24）mm，差异均有统计学意义（t=3.576、2.722、2.774，均P<0.05）。干预后，干预组的PANAS中正性情绪（PA）评分为（37.61±1.39）分，高于对照组（35.43±1.41）分，负性情绪（NA）评分为（15.41±1.27）分，低于对照组（17.47±1.40）分，干预组SSS评分为（28.16±7.74）分，低于对照组（32.98±9.04）分，差异均有统计学意义（t=7.707、7.629、2.835，均P<0.05）。干预后，干预组SAQ中心绞痛发作情况、心绞痛稳定性、疾病认知程度、疗效满意度评分为（89.27±9.29）、（82.93±9.35）、（75.24±8.38）、（81.05±8.15）分，高于对照组（83.68±9.07）、（77.67±8.86）、（70.85±8.21）、（76.36±7.73）分，差异均有统计学意义（t=3.014、2.858、2.619、2.923，均P<0.05）。干预组的总并发症发生率为4.08%（2/49），低于对照组的18.37%（9/49），差异有统计学意义（χ²=5.018，P=0.025）。结论　运动耐力细节护理显著改善了AMI患者的术后心功能指标，减轻了躯体化症状和心绞痛症状，改善了情绪状态，有效减少了并发症的发生，显示了其在临床应用中的重要价值。

关键词:

急性心肌梗死, 运动耐力细节护理, 心功能, 正性负性情绪, 并发症

Li Jiaojiao, Luo Kemei.

Impact of exercise endurance detail care on postoperative cardiac function and complications in patients with acute myocardial infarction [J]. International Medicine and Health Guidance News, 2024, 30(14): 2322-2327.

李姣姣罗科梅.

运动耐力细节护理对急性心肌梗死患者术后心功能及并发症的影响 [J]. 国际医药卫生导报, 2024, 30(14): 2322-2327.

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