基于奥马哈理论的围手术期全程康复管理对TAVR患者心理应激、6 min步行距离及并发症的影响

目的 探讨基于奥马哈理论的围手术期全程康复管理对经导管主动脉瓣置换术（transcatheter aortic valve replacement，TAVR）患者心理应激、6 min步行距离及并发症的影响。 方法 选取我院74例TAVR患者，采用随机数字表法分为2组，各37例。对照组采取传统围术期护理，在对照组基础上，观察组采取基于奥马哈理论的围手术期全程康复管理。统计2组并发症、护理满意度及护理前后心理应激、心功能指标、健康行为（health promotionlifestyleprofile-Ⅱ，HPLP-Ⅱ）、6 min步行距离及生活质量。 结果 观察组干预后左心室舒张末期内径、跨瓣压差较对照组低，主动脉瓣面积、左心室射血分数高于对照组（P＜0.05）；观察组干预后特质焦虑（Trait Anxiety Inventory，T~AI）、状态焦虑（State Anxiety Inventory，S~AI）评分低于对照组（P＜0.05）；观察组干预后HPLP-Ⅱ量表6个维度评分高于对照组（P＜0.05）；观察组术后3个月、6个月生活质量及6 min步行距离高于对照组（P＜0.05）；2组并发症比较差异无统计学意义（P＞0.05）。 结论 基于奥马哈理论的围手术期全程康复管理应用于TAVR患者，可减轻其心理应激，提高患者健康促进生活方式水平，预防并发症发生，在改善患者心功能、运动耐力和提高患者护理满意度方面具有积极意义。

The impact of the whole course of rehabilitation management during the perioperative period based on Omaha theory on the psychological stress, 6-min walking distance and complications of TAVR patients

Objective To investigate the effects of the whole course of rehabilitation management during the perioperative period based on Omaha theory on psychological stress, 6-min walking distance(6MWD) and complications of patients undergoing transcatheter aortic valve replacement(TAVR).Methods A total of 74 TAVR patients in our hospital were selected and grouped according to the random number table method, with 37 cases in each group. The control group was given traditional perioperative care, and on the basis of the control group, the observation group was given the whole course of rehabilitation management during the perioperative period based on the Omaha theory. The complications, the degree of nursing satisfaction, psychological stress before and after nursing, cardiac function index, health promotionlifestyle profile-Ⅱ(HPLP-Ⅱ), 6MWD and quality of life were calculated in the two groups.Results After the intervention, the left ventricular end-diastolic diameter and transvalvular pressure difference in the observation group were lower than those in the control group, and the aortic valve area and left ventricular ejection fraction were higher than those in the control group(P＜0.05). The scores of trait anxiety inventory(T-AI) and state anxiety inventory(S-AI) in the observation group after intervention were lower than those in the control group(P＜0.05). The scores of 6 dimensions of HPLP-Ⅱ scale in the observation group were higher than those in the control group after intervention(P＜0.05). The quality of life and 6MWD in the observation group were higher than those in the control group at 3 and 6 months after operation(P＜0.05). The complications in the two groups were not significantly different(P＞0.05).Conclusion The application of whole course of rehabilitation management during the perioperative period based on Omaha theory to TAVR patients can alleviate their psychological stress, improve the health and lifestyle of patients, and prevent complications. It has positive significance in improving patients′ cardiac function and exercise endurance, and increasing the satisfaction degree of patients.