摘要
目的:以系统评价的方法评估心脏康复护理模式对急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术后心功能的影响.方法:检索数据库有关心脏康复对AMI患者PCI术后心功能影响的文献,包括中国知网(CNKI)、维普数据库(VIP)、万方数据库、中国生物医学文献数据库(CBM)、PubMed、Embase等,检索时间截止至2023年1月,筛选符合要求的随机对照研究.结果:共纳入11项研究,结果显示:心脏康复组左室射血分数(MD=5.26,95％CI(3.70,6.82),P=0.001)、6min 步行距离(MD=61.02,95％CI(27.43,94.62),P=0.001)、摄氧量峰值(MD=3.64,95％CI(2.38,4.90),P=0.001)、无氧阈(MD=3.08,95％CI(1.47,4.69),P=0.001)均显著高于对照组;左室收缩末期内径(MD=-1.83,95％CI(-2.36,-1.30),P=0.001)、左室舒张末期内径(MD=-3.43,95％CI(-5.01,-1.85),P=0.001)均显著小于对照组.结论:急性心肌梗死患者PCI术后采用心脏康复护理可显著改善心功能,增加运动耐量,改善生活质量,但由于部分指标有较高的异质性,仍需进一步评估.
Abstract
Objective:To assess the effect of cardiac rehabilitation nursing mode on cardiac function in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI)with a systematic review meth-od.Methods:We searched databases,including CNKI,VIP,Wanfang,CBM,PubMed,Embase etc.,for literature on influence of cardiac rehabilitation on cardiac function in AMI patients after PCI before Jan 2023.Eligible ran-domized controlled tests(RCTs)were screened.Results:A total of 11 studies were enrolled and the results indicated that compared with control group,there were significant rise in left ventricular ejection fraction(MD=5.26,95％CI(3.70,6.82),P=0.001),6min walking distance(MD=61.02,95％CI(27.43,94.62),P=0.001),peak ox-ygen uptake(VO2,MD=3.64,95％CI(2.38,4.90),P=0.001)and anaerobic threshold(AT,MD=3.08,95％CI(1.47,4.69),P=0.001),and significant reductions in left ventricular end-systolic diameter(MD=-1.83,95％CI(-2.36,-1.30),P=0.001)and left ventricular end-diastolic diameter(MD=-3.43,95％CI(-5.01,-1.85),P=0.001)in cardiac rehabilitation group.Conclusion:Cardiac rehabilitation nursing can signifi-cantly improve cardiac function,exercise endurance and quality of life in patients with acute myocardial infarction after PCI.However,due to high heterogeneity of some indexes,further evaluation is still needed.
万方数据