早期四级活动管理方案在冠状动脉旁路移植术患者中的应用研究

目的构建冠状动脉旁路移植术后患者早期四级活动管理方案,并探讨其实施效果。方法选择2018年10月1日至2019年3月31日入住上海市某三级甲等医院心脏外科ICU行冠状动脉旁路移植术患者200例,2018年10月1日至12月31日收治的92例患者为对照组,2019年1月1日至3月31日收治入的108例患者为干预组。对照组实施术后常规护理,干预组在对照组的基础上实施早期四级活动管理方案,比较两组患者的机械通气时间、肺部感染发生率、谵妄发生率及患者的住院满意度。结果两组患者在呼吸机使用时间、肺部感染发生率、谵妄发生率及患者的满意度方面差异均具有统计学意义(P<0.01或P<0.05)。结论早期四级活动管理方案能缩短冠状动脉旁路移植术患者机械通气时间,降低术后肺部感染和谵妄的发生率,提高患者的住院满意度,是术后患者安全、可行的康复方案。

Application of early four-stage activity management program in patients after coronary artery bypass grafting

Objective To evaluate the effect of early four-stage activity management program for patients after coronary artery bypass grafting(CABG).Methods A total of 200 patients after CABG were divided into control group(n=92)that from October to December in 2018 and intervention group(n=108)that from January to March in 2019.The control group received routine postoperative care,and the intervention group were implemented early four-level activity management program based on the control group.The mechanical ventilation time,the incidence of pulmonary infection and spasticity,and the hospitalization satisfaction of patient were compared between the two groups.Results There were significant differences in ventilator use time,incidence of pulmonary infection,incidence of spasticity,and patient satisfaction between the two groups(P<0.01 or P<0.05).Conclusion The early four-stage activity management program can shorten the mechanical ventilation time of patients after CABG,reduce the incidence of postoperative pulmonary infection and spasm,and improve the hospitalization satisfaction of patients.It is a safe and feasible rehabilitation plan for patients after CABG.