心脏康复训练结合心理干预对急性心肌梗死经皮冠状动脉介入治疗术后高危患者的疗效  

Effects of cardiac rehabilitation combined with psychological invention on clinical efficacy in high-risk patients with acute myocardial infarction after emergent percutaneous coronary intervention

作　　者：赵爱纯[1] 赵晓峰 Zhao Aichun;Zhao Xiaofeng(Cardiology Department,Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010,China)

机构地区：[1]首都医科大学附属北京中医医院心内科,100010

出　　处：《中华行为医学与脑科学杂志》2019年第12期1081-1084,共4页Chinese Journal of Behavioral Medicine and Brain Science

摘　　要：目的探讨I期心脏康复训练配合结构式心理干预对急性心肌梗死急诊经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后高危患者临床疗效的影响。方法选择120例急性心肌梗死急诊PCI术后的高危患者,根据随机数字表法分为试验组和对照组,每组各60例。试验组给予术后I期心脏康复训练配合结构式心理干预的方法,对照组给予术后常规治疗的方法。比较两组入组前、术后1个周焦虑自评量表(SAS)、抑郁自评量表(SDS)评分的变化,比较两组入组前、术后1个周、1个月、6个月的左室射血分数、左室舒张末径的变化,比较两组术后6个月心源性死亡、再发心肌梗死的心脏不良事件发生率。结果试验组术后1周SAS评分[(36.38±5.15)分]低于对照组[(42.10±5.79)分,t=2.313,P<0.05],试验组术后1周SDS评分[(37.09±5.56)分]低于对照组[(43.85±5.33)分,t=2.330,P<0.05];试验组左室射血分数术后1周[(45.08±4.41)%]显著高于对照组[(42.81±3.83)%],术后1个月[(48.93±4.39)%]显著高于对照组[(44.61±4.35)%](t=2.209,2.224,均P<0.05);试验组左室舒张末径术后1个月[(54.74±4.01)mm]显著低于对照组[(57.81±4.49)mm],术后6个月[(52.21±2.82)mm]显著低于对照组[(55.65±3.88)mm](t=2.413,2.297,均P<0.05),其余时间点两组比较差异无统计学意义(均P>0.05);试验组术后6个月心源性死亡率(8.9%)较对照组(24.1%)显著降低[HR(95%CI):0.317(0.128~0.835),P<0.05],试验组再发心肌梗死率(14.2%)较对照组(42.2%)显著降低[HR(95%CI):0.263(0.125~0.548),P<0.05]。结论I期心脏康复训练配合结构式心理干预可改善急性心肌梗死急诊PCI术后高危患者的焦虑抑郁,改善心功能,降低心源性死亡、再发心肌梗死的心脏不良事件发生率。Objective To investigate the effects of stage I cardiac rehabilitation combined with structural psychological invention high-risk patients with acute myocardial infarction(AMI)treated by emergent percutaneous coronary intervention(PCI).Methods Totally 120 patients with AMI that received emergent PCI were randomized into experimental group(n=60)and control group(n=60).The experimental group started stage I cardiac rehabilitation combined with structural psychological invention after emergency PCI.The control group received routine treatment.Self-rating Anxiety Scale(SAS)and Self-rating depression Scale(SDS)scores were compared in both groups at before PCI and 1 week after PCI.Left ventricular ejection fraction(LVEF)and left ventricular end-diastolic diameter(LVEDD)were compared in both groups at before PCI and 1 week,1 month and 6 months after PCI.The incidence of adverse cardiac events including cardiac death and recurrence myocardial infarction were compared between the two groups at 6 months after PCI.Results The SAS score in the experimental group(36.38±5.15)was lower than that in the control group(42.10±5.79)in 1 week after PCI(t=2.313,P<0.05).The SDS score in the experimental group(37.09±5.56)was lower than that in the control group(43.85±5.33)in 1 week after PCI(t=2.330,P<0.05).The LVEF in the experimental group((45.08±4.41)%)was significantly higher than that in the control group((42.81±3.83)%)in 1 week after PCI(t=2.209,P<0.05).The LVEF in the experimental group((48.93±4.39)%)was significantly higher than that in the control group((44.61±4.35)%)in 1 month after PCI(t=2.224,P<0.05).The LVEDD in the experimental group((54.74±4.01)mm)was significantly lower than that in the control group((57.81±4.49)mm)in 1 month after PCI(t=2.413,P<0.05).The LVEDD in the experimental group((52.21±2.82)mm)was significantly lower than that in the control group((55.65±3.88)mm)in 6 month after PCI(t=2.297,P<0.05).And there were no significant difference between the two groups at other time point(all P>0.05).The foll

关 键 词：急性心肌梗死 急诊介入 高危 I期心脏康复 结构式心理干预 

分 类 号：R473.5[医药卫生—护理学]