门诊和院外实施运动训练对经皮冠状动脉腔内成形术及支架术后患者心功能恢复的作用  

Effects of exercises at outpatient clinic and out of hospital on the recovery of cardiac function in patients after percutaneous transluminal coronary angioplasty or intracoronary stent implantation

作　　者：陈刚[1] 李京平[1] 

机构地区：[1]卫生部北京医院康复科,北京市100730

出　　处：《中国临床康复》2004年第30期6545-6547,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:比较经皮冠状动脉腔内成形术(percutaneoustransluminalcoronaryangioplasty,PTCA)或支架术后患者进行门诊和院外康复运动的效果,探讨PTCA或支架术后患者康复运动的特点和方法以及制定康复运动处方的原则。方法:根据术后无胸闷、胸痛等症状和体征,安静状态下心率<90次/min,血压<140/90mmHg(1mmHg=0.133kPa),心电图ST段压低<1mm,无运动诱发的心率失常等标准,共有在卫生部北京医院内科住院的51例患者入选,分为门诊康复运动组(n=24)和院外自我监护下康复运动组(n=27),进行运动心肺功能评定,制定康复运动处方,进行8周康复运动训练。结果:康复运动训练后,两组患者的运动时间、最大运动功率、最大代谢当量、最大氧耗量和每分通气量均较训练前有显著提高(t=2.43～7.56,P<0.05),而两组患者运动时间犤(9.02±2.58),(9.58±2.44)min犦、最大运动功率犤(122.92±32.90),(129.63±33.28)W犦、最大代谢当量犤(7.59±1.77),(7.53±1.36)METs犦和最大氧耗量犤(14.18±3.67),(1.90±0.45)L/min犦等反映患者康复运动效果的各项主要指标比较,差异均无显著性意义(P>0.05)。结论:康复运动训练使PTCA及支架术后患者的体力、运动耐力和肺通气容量提高,心脏功能容量增加。院外自我监护下康复运动与门诊心电监护下康复运动?AIM:To compare the effect of clinic based and home based exercise training on patients after percutaneous transluminal coronary angioplasty(PTCA) or intracoronary stent implantation,explore its features and methods and formulate the principles of physical exercise prescription.METHODS:A total of 51 inpatients in the Department of Internal Medicine,Beijing Hospital of Ministry of Public Health were selectecd,and divided into clinic based exercise training group(n=24) and home based exercise group(n=27) on the basis of criteria as follows:no symptoms and physical sign of breast muffle,pain,heart rate under quiet status below 90 beat per minute,blood pressure below 140/90 mm Hg,ST portion of electrocardiograph below 1 mm,without abnormal heart rate induced by exercise.They were given evaluation on cardiorespiratory function and 8 week exercise training,with the principles of physical exercise prescription formulated.RESULTS:After exercise training,total exercise time,maximal work load,maximal metablic equivalents(METs),maximal oxygen consumption(VO2max) and minute ventilation(VE) were significantly improved in the patients of both groups(t=2.43 to 7.56,P< 0.05).There were no significant differences in various main markers which reflected the effect of rehabilitation exercise such as total exercise time[(9.02±2.58),(9.58±2.44) minutes],maximal work load[(122.92±32.90),(129.63±33.28) W],maximal metablic equivalents[(7.59±1.77),(7.53±1.36) METs] and maximal oxygen consumption[(14.18±3.67),(1.90±0.45) L per minute] between the groups.CONCLUSION:Rehabilitation exercise training in patients after PTCA or intracoronary stent implantation can increase physical work capacity,exercise tolerance and pulmonary ventilation and cardiac functional capacity.Home based exercise training has the same beneficial effect as clinic based exercise training.

关 键 词：康复运动 患者 术后 支架术 门诊 院外 经皮冠状动脉腔内成形术 最大 运动训练 运动时间 

分 类 号：R541.4[医药卫生—心血管疾病] R654[医药卫生—内科学]