急性心肌梗死患者急诊PCI术后心脏康复方案研究


摘  要

  急性心肌梗死是心血管系统的危急重症,急诊经皮冠状动脉介入治疗(PCI)是其主要的再灌注治疗方法,但术后患者仍面临诸多问题,如运动耐力下降、心理障碍等。为改善患者预后,本研究旨在构建并评估适用于急性心肌梗死患者急诊PCI术后的个性化心脏康复方案。选取某院收治的200例急性心肌梗死急诊PCI术后患者作为研究对象,依据随机数字表法分为观察组与对照组各100例,对照组接受常规护理,观察组在常规护理基础上实施心脏康复方案,该方案涵盖健康教育、有氧运动训练、抗阻训练、心理干预及营养指导等内容。通过6分钟步行试验、明尼苏达生活质量和焦虑抑郁量表等指标进行为期3个月的随访评估。结果显示,观察组患者6分钟步行距离较对照组明显增加,生活质量评分显著提高,焦虑抑郁情绪得到有效缓解,差异具有统计学意义。这表明所构建的心脏康复方案有助于改善急性心肌梗死患者急诊PCI术后的身体机能和心理健康状况,创新性地将多种康复措施整合为系统化方案,为临床提供了一种有效的康复模式,对提升患者生存质量具有重要意义。

关键词:急性心肌梗死;急诊PCI术后;心脏康复方案;运动耐力;心理干预


Abstract

  Acute myocardial infarction is a critical condition of the cardiovascular system, and emergency percutaneous coronary intervention (PCI) serves as the primary reperfusion therapy. However, postoperative patients still encounter numerous issues such as decreased exercise endurance and psychological disorders. To improve patient prognosis, this study aims to construct and evaluate an individualized cardiac rehabilitation program tailored for patients who have undergone emergency PCI for acute myocardial infarction. A total of 200 patients with acute myocardial infarction who underwent emergency PCI at a hospital were selected as subjects and divided into observation and control groups of 100 cases each according to a random number table method. The control group received routine care, while the observation group was provided with a cardiac rehabilitation program based on routine care. This program included health education, aerobic exercise training, resistance training, psychological interventions, and nutritional guidance. Follow-up assessments over a period of three months were conducted using indicators such as the six-minute walk test, Minnesota Living with Heart Failure Questionnaire, and anxiety and depression scales. The results showed that the six-minute walking distance in the observation group significantly increased compared to the control group, quality of life scores markedly improved, and anxiety and depression symptoms were effectively alleviated, with statistically significant differences. This indicates that the constructed cardiac rehabilitation program contributes to enhancing physical function and mental health status in patients after emergency PCI for acute myocardial infarction, innovatively integrating multiple rehabilitation measures into a systematic program, providing an effective rehabilitation model for clinical practice, and playing a significant role in improving patient survival quality.

Keywords:Acute Myocardial Infarction;Emergency Pci Post-Operatively;Cardiac Rehabilitation Program;Exercise Endurance;Psychological Intervention


目  录
摘  要 I
Abstract II
引  言 1
第一章 急性心肌梗死与急诊PCI概述 2
1.1 急性心肌梗死发病机制 2
1.2 急诊 2
第二章 心脏康复方案设计原则 5
2.1 康复目标设定依据 5
2.2 个体化康复方案制定 5
2.3 康复阶段划分标准 6
第三章 心脏康复具体实施措施 8
3.1 运动疗法的应用 8
3.2 营养支持策略 8
3.3 心理干预方法 9
第四章 康复效果评估与优化 10
4.1 短期疗效评价指标 10
4.2 长期预后跟踪分析 10
4.3 方案改进方向探讨 11
结  论 12
参考文献 13
致  谢 14
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