Outcome-oriented integrated zero-defect nursing combined with respiratory functional exercise in the perioperative period of patients with heart bypass.

OBJECTIVE: This study aimed to explore the perioperative application of outcome-oriented integrated zero-defect nursing combined with respirational function exercise in patients undergoing cardiac bypass grafting.

METHODS: In this retrospective study, the clinical data of 90 patients with bypass surgery in the General Ward of Cardiac Surgery, Beijing Anzhen Hospital Capital Medical University were collected. The patients were assigned into groups A (n=30), B (n=30), and C (n=30) according to different nursing methods. Group A received outcome-oriented integrated zero-defect nursing in combination with respiratory functional exercise administration, group B received outcome-oriented integrated zero-defect nursing, and group C received routine nursing. The postoperative recovery was detected. Left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVDD), left ventricular end-systolic diameter (LVSD), and interventricular septal thickness (IVST) were assessed among the three groups pre- and post-intervention. The forced expiratory volume in one second (FEV1), forced vital capacity (FVC), arterial partial pressure of oxygen (PaO2), and arterial partial pressure of carbon dioxide (PaCO2), and blood gas indices were measured before operation and three days after extubation. The occurrence of complications was compared. The quality of life among groups pre- and post-administration was evaluated by the Generic Quality of Life Inventory (GQOLI-74).

RESULTS: The length of hospital stay, first exhaust time, first excretion interval, and intestine sound improvement time in groups A and B were markedly decreased compared with those in group C, and these markers in group A were markedly decreased compared with those in group B (all P<0.05). After the intervention, the levels of LVEF, LVDD, LVSD, IVST and FVC in group A were more improved compared with those in groups B and C, and the levels of FEV1, PaO2 and PaCO2 were more improved compared to those in group C (all P<0.05). The incidences of hypotension, subcutaneous hyperemia, pericardial tamponade, short-burst ventricular tachycardia, subacute stent thrombosis and pulmonary complications in group A and group B (13.33%, 23.33%) were significantly lower than those in group C (50.00%) (all P<0.05). After the intervention, the results of social function, physical, psychological function, and material lifecycle status in group A and B were significantly enhanced compared with those in group C, and the indicators in group A were appreciably better compared with those in group B (all P<0.05).

CONCLUSION: Outcome-oriented zero-defect integrated nursing in combination with respirational function exercise can efficiently promote the postoperative revival of patients undergoing heart bypass operation, improve their cardiopulmonary function, diminish the occurrence of complications, and improve their life quality.