Construction And Effect Evaluation Of The First-stage Exercise Rehabilitation Program For STEMI Patients After PCI

Objective1.Based on evidence-based nursing,review and analyze relevant guidelines,systematic reviews,expert consensus and other documents,combine clinical practice,and discuss through expert meetings to construct acute ST-elevation myocardial infarction(STEMT))The clinical practice program of phase Ⅰ exercise rehabilitation for patients after PCI to promote the development of phase Ⅰ rehabilitation care for STEMI patients after PCI.2.Carry out an empirical study of the first-stage exercise rehabilitation practice program for patients with acute STEMI after PCI,evaluate the effect of the program in improving patients’ cardiac function,ability of daily living,and psychological status,and provide reference for related research.Method1.Establish a phase Ⅰ exercise rehabilitation team for STEMI patients after PCI,search Cochrane Library,Pub Med,DARE,Science Direct,China Knowledge Network,Yimaitong and other domestic and foreign databases to obtain evidence of stage Ⅰ exercise rehabilitation for STEMI patients after PCI.The quality evaluation and evidence grading were carried out on the type of literature,and the first-stage exercise rehabilitation plan for STEMI patients after PCI was preliminarily drawn up.After discussion at the expert meeting,the final stage-1 exercise rehabilitation plan for STEMI patients after PCI was formed.2.Convenience sampling was used to select 75 patients in the cardiology department of a tertiary first-class hospital in Shandong Province from September 2020 to December 2020 who were diagnosed with STEMI and were treated with PCI as the study objects.38 cases in the intervention group and the control group 37 cases.The control group took routine care,and the intervention group was given the first-stage exercise rehabilitation program after PCI for STEMI patients on the basis of routine care.Observe the differences in indicators such as 6MWT distance,FIM scale score,RCSQ sleep scale score,GAD-7 scale and PHQ-9 questionnaire score,length of stay in the two groups before and after intervention.Result1.Through literature research and analysis,13 articles were finally included,including 6 guidelines,4 systematic reviews/Meta analysis,and 3 expert consensus.After the quality evaluation and detailed analysis of the literature,the initial stage Ⅰ after PCI for patients with acute STEMI was formed Sports rehabilitation program.Nine clinical experts were invited to discuss and evaluate the plan,and finally summarized 4 opinions to form the final plan for the first-stage exercise rehabilitation of patients with acute STEMI after PCI.2.There was no statistical difference in the differences between the two groups of patients in terms of combined diseases,number of stents,and cardiac function Killip classification(P>0.05);before discharge,the 6-min walk distance of the intervention group was better than that of the control group,P<0.05,the difference Statistically significant;RCSQ sleep scale scores showed no difference in noise scores between the two groups after intervention,but the sleep scores of patients in the intervention group were significantly higher than those in the control group,P<0.05,the difference was statistically significant;FIM scores showed that after intervention,the intervention group The scores and total scores of the patients in self-care activities,sphincter control,transfer,marching,social cognition and other dimensions were better than those of the control group,P<0.05,the difference was statistically significant,but there was no statistical difference in the communication dimension scores between the two groups(P>0.05);After the intervention,the scores of GAD-7 and PHQ-9 in the intervention group were lower than those in the control group,P<0.05,there was a significant statistical difference;the hospital stay in the intervention group was 6.501.20 days,and the hospital stay in the control group It was 8.03 0.96,P<0.001,the difference was statistically significant.ConclusionThe Phase Ⅰ exercise rehabilitation program for STEMI patients after PCI is based on evidence-based construction,which is scientific and reliable,and has high clinical feasibility.Clinical practice has found that this program is beneficial to alleviate the adverse effects of long-term bed rest after the operation.Cardiac function and exercise endurance can improve patients’ sleep disorders,relieve patients’ anxiety and depression and other negative emotions,improve patients’ ability of daily living,and shorten hospitalization time,which can provide clinical guidance.