【作者】 杨青；

【导师】 方芳；

【作者基本信息】 上海交通大学 ， 护理学， 2020， 硕士

【摘要】 目的形成适用性良好的心脏外科手术老年患者术后早期康复方案,验证术后早期康复方案对患者运动功能水平等方面的作用,为提高老年患者参与心脏康复的适应性提供可行的康复方案。方法1.通过文献综述和培训学习、咨询专家形成本研究的术后早期康复方案。选取在上海市某三甲医院行心脏外科手术、年龄≥60周岁的患者30例,给予常规康复加术后早期康复方案,根据公式计算患者对方案的依从性,检验方案在心脏外科手术老年患者中的适用性。2.选取2018年11月至2020年1月在上海市某三甲医院行心脏外科手术、年龄≥60周岁的患者79例,分为对照组43例、干预组37例。对照组给予常规康复,干预组给予常规康复和术后早期康复方案。比较两组患者间运动功能水平(Barthel指数和Rivermead运动指数)、氧饱和度、ICU谵妄发生率、炎性指标(白细胞计数和C反应蛋白水平)等方面的差异。结果1.方案的适用性检验中,对术后早期康复方案依从性好的患者占70%。2.方案的效果验证中,干预后干预组患者术后第7天的Barthel指数、出院前Rivermead运动指数均优于对照组(P<0.05)。两组在转出ICU前的氧饱和度、ICU谵妄发生率、术后第七天的血白细胞计数及C反应蛋白水平、术后肺部感染发生率、术后住院天数等方面的差异无统计学意义(P>0.05)。结论1.术后早期康复方案在心脏手术老年患者中的应用安全可行。2.术后早期康复方案可提高心脏手术老年患者短期的运动功能水平。更多还原

【Abstract】 ObjectiveForm the postoperative early rehabilitation program with good applicability for elderly patients undergoing cardiac surgery and verify the effect of the program on patients’ motor function ability in order to provide feasible rehabilitation program for improving elderly patients’ adaptability towards cardiac rehabilitation.Methods1.Form the postoperative early rehabilitation program through literature review,learning from training course,and consulting experts.30 patients aged more than 60 years old who underwent cardiac surgery at a tertiary hospital in Shanghai were selected and given routine rehabilitation plus the postoperative early rehabilitation program.The patient’s adherence with the program was calculated according to the formula to represent the applicability of the program.2.A total of 79 patients aged 60 years or older who underwent cardiac surgery at a tertiary hospital in Shanghai from November 2018 to January 2020 were selected and divided into a control group of 43 patients and an intervention group of 37 patients.The control group was given routine rehabilitation,and the intervention group was given routine rehabilitation plus the postoperative early rehabilitation program.Compare The differences between the two groups in motor functional ability(Barthel Index and Rivermead Mobility Index),incidence of ICU delirium,oxygen saturation,inflammation indexes(white blood cell count and C-reactive protein level),etc.Results1.In the applicability test of the program,70% patients have good adherence with the early postoperative rehabilitation program.2.In the verification of the effect of the program,after the intervention the Barthel Index on the 7th postoperative day and the Rivermead Mobility Index on the day before discharge were better in the intervention group than those in the control group(P<0.05).There was no significant difference between the two groups in terms of oxygen saturation,incidence of ICU delirium,postoperative inflammation indexes,incidence of lung infection,and the length of postoperative hospital stay(P>0.05).Conclusion1.The application of the postoperative early rehabilitation program in elderly patients undergoing cardiac surgery is safe and feasible.2.The postoperative early rehabilitation program can improve the short-term motor functional ability of elderly patients undergoing cardiac surgery.更多还原