早期运动干预对急性心肌梗死患者并发症及出院后生活自理能力的影响  

Effect of early exercise therapy on the complication and self-care ability in patients with acute myocardial infarction after discharge

作　　者：冯新[1] 

机构地区：[1]东营市胜利石油管理局中心医院急救中心,山东省东营市257034

出　　处：《中国临床康复》2004年第30期6548-6549,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:探讨早期康复疗法对无并发症的急性心肌梗死患者的病情转归及预后的影响。方法:20例接受康复治疗的急性心肌梗死患者按医师制定的体力活动逐步增加的方案进行康复治疗,三四周时作超声心动图测定左室舒张末期内径、左室收缩末期内径、左室射血分数,进行Holter检查24hST段压低时限及心律失常发生情况。与同期不进行康复治疗的20例患者进行对照。结果:早期康复组与对照组在左室舒张末期内径犤(55.55±10.62)和(56.45±9.57)mm犦、左室收缩末期内径犤(45.85±11.03)和(43.70±9.65)mm犦、左室射血分数、Holter中LownⅢ级以上室性心律失常发生数(2例和3例)及ST段压低时限犤(25.26±10.98)和(30.17±13.68)h犦及梗死后心绞痛(4例和3例)、住院期死亡数(0例和0例)等的构成在统计学上差异均无显著性意义(χ2或t=0.00～1.25,P>0.05);康复组坠积性肺炎的发生数(0例和6例)和平均住院天数犤(18.45±10.13)和(25.65±14.35)d犦均低于对照组,差异有显著性意义(t=7.06,χ2=1.83,P<0.05),康复组出院时达到生活自理18例,对照组9例,差异有显著性意义(t=9.23,P<0.01)。结论:无合并症急性心肌梗死患者实行早期康复治疗可以促进康复,改善预后。AIM:To explore the effects of early rehabilitation program on the development of the disease and the prognosis in patients with acute myocardial infarction(AMI) without compliction.METHODS:Rehabilitation programs of stepwise increasing physical activity,which were structured by the physician,were performed on 20 AMI patients.Left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD) and left ventricular ejection fraction(LVEF) were measured by ultrasonic cardiogram after 3 or 4 weeks.At the same time,limitation time of ST segment depression and ventricular arrhythmias in 24 hours were studied by Holter examination.The results were compared with other 20 AMI patients who received no rehabilitation treatment.RESULTS:No significant differences were observed in terms of LVEDD[(55.55±10.62) vs(56.45±9.57) mm],LVESD[(45.85±11.03) vs(43.70±9.65) mm],LVEF,cases of Lown classification of ventricular arrhythmias >Ⅲ(2 vs 3) and time limitation of ST segment depression[(25.26±10.98) vs(30.17±13.68) hours] in Holter monitoring,cases of post infarction angina(4 vs 3),and hospital mortality(0 vs 0) between the early rehabilitation group and control group(χ2 or t=0.00 to 1.25,P >0.05).The occurrence of hypostatic pneumonia and average days of hospitalization in the rehabilitation group[0,(18.45±10.13) days] were significantly lower than those in the control group[6, (25.65±14.35) days](t=7.06,χ2=1.83,P< 0.05).There were 18 cases in the rehabilitation group and 9 cases in the control group that could take care of themselves,and the difference was significant(t=9.23,P< 0.05).CONCLUSION:Early rehabilitation program can improve the recovery and prognosis of AMI patients without complications.

关 键 词：患者 并发症 急性心肌梗死 对照组 ST段压低 左室 出院后 生活自理能力 显著性 结论 

分 类 号：R542.22[医药卫生—心血管疾病] R541[医药卫生—内科学]