摘要
目的 分析在重症瓣膜病患者中应用术前心脏康复干预联合动机访谈对患者心肌功能、生活质量及查尔森基础疾病权重指数(WIC)的影响.方法 将2018年9月至2019年9月在上海市瑞金医院北院重症医学科接受治疗的80例重症瓣膜病患者纳入研究,并通过数字随机表法分为对照组和观察组各40例,对照组患者给予常规护理,观察组患者给予术前心脏康复干预联合动机访谈.比较两组患者术后的临床指标,检测左室射血分数(LVEF)、左房容积指数(LAVI)、舒张前期二尖瓣血流速度与舒张前期二尖瓣环运动速度比(E/e′);通过Barthel指数评估患者术后日常生活能力及6 min步行实验(6MWT)情况;通过SF-36量表评价患者术后生活质量;采用查尔森基础疾病权重指数(WIC)评估患者预后效果.结果 两组患者在机械通气时间、ICU停留时间、住院时间和并发症方面比较,差异均无统计学意义(P>0.05);观察组患者术后LVEF、LAVI、E/e′分别为(60.64±5.51)%、(28.24±4.57)mL/m2、(9.57±3.28),对照组分别为(51.68±6.54)%、(31.64±6.23)mL/m2、(912.28±3.16),观察组明显优于对照组,差异均具有统计学意义(P<0.05);观察组患者术后Barthel指数和6WMT分别为(80.14±6.83)分、(319.11±48.86)m,明显高于对照组的(75.24± 7.43)分、(287.34±62.71)m,差异均具有统计学意义(P<0.05);观察组患者的术后生活质量各项评分明显高于对照组,差异均具有统计学意义(P<0.05);观察组患者术后WIC评分为(0.81±1.21)分,明显低于对照组的(1.83±1.36)分,差异均具有统计学意义(P<0.05).结论 术前心脏康复干预联合动机访应用于重症瓣膜病患者中,能够有效增强患者的心肌功能,加强运动耐量,提升生活自理能力,明显改善预后,具有较高的应用价值.
Objective To analyze the effect of preoperative cardiac rehabilitation intervention combined with motivational interviewings on myocardial function,quality of life,and Charlson's weighted index of comorbidities(WIC)in patients with severe valvular disease.Methods Eighty patients with severe valvular disease,who admitted to Department of Critical Medicine of the North Hospital of Shanghai Ruijin Hospital from September 2018 to September 2019,were selected and divided into the control group and the observation group according to random number table method,with 40 cases in each group.The patients in the control group were given routine care,and the patients in the observation group were given preoperative cardiac rehabilitation interventions combined with motivational interviewings.The clinical indicators,including left ventricular ejection fraction(LVEF),left atrial volume index(LAVI),pre-diastolic mitral valve blood flow velocity and pre-diastolic mitral annulus motion velocity ratio(E/e')of the two groups were compared and investigated;Barthel index was used to evaluate patients'postoperative daily living ability and 6-minute walking test(6MWT);SF-36 was used to evaluate and observe patients'postoperative quality of life;Charlson's weighted index of comorbidities was used to evaluate the patients'prognosis.Results The results of the two groups of patients showed that there was no significant difference between the two groups in terms of mechanical ventilation time,ICU stay time,length of hospital stay,and complications(all P>0.05);After the treatment,LVEF,LAVI,E/e'of the observation group were(60.64±5.51)%,(28.24±4.57)mL/m2,9.57±3.28,respectively,which were significantly better than corresponding(51.68±6.54)%,(31.64±6.23)mL/m2,912.28±3.16 of the control group(all P<0.05).Barthel index and 6WMT in the observation group were(80.14±6.83)points and(319.11±48.86)m,which were significantly higher than corresponding(75.24±7.43)points and(287.34±62.71)m in the control group(P<0.05).The scores of postoperative q
作者
李碧波
朱韦霞
卜雪莉
LI Bi-bo;ZHU Wei-xia;PU Xue-li(Department of Critical Medicine,the North Hospital of Shanghai Ruijin Hospital,Shanghai 201801,CHINA)
出处
《海南医学》
CAS
2020年第6期813-816,共4页
Hainan Medical Journal
关键词
心脏康复干预
心肌功能
重症瓣膜病
动机访谈
生活质量
Cardiac rehabilitation intervention
Myocardial function
Severe valvular disease
Motivational interviewing
Quality of life
