Ⅰ期心脏康复对急性ST段抬高型心肌梗死急诊PCI术后患者心功能的影响  

Influence of phase I cardiac rehabilitation on heart function in patients with acute ST-segment elevation myocardial infarction after emergent PCI

作　　者：蹇祥玉[1] 路海云[2] 叶秀莲[1] 罗莹怡[1] 陈春棉[1] 李琛[1] Jian Xiangyu;Lu Haiyun;Ye Xiulian;Luo Yingyi;Chen Chunmian;Li Chen(Department of Cardiology,Second People's Hospital of Foshan City,Guangdong Province,Foshan 528000,China;不详)

机构地区：[1]佛山市第二人民医院心内科,佛山528000 [2]佛山市第二人民医院护理部,佛山528000

出　　处：《中国循证心血管医学杂志》2019年第12期1484-1486,1490,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：广东省佛山市科技局基金立项项目(201308026);佛山市医学重点专科培育项目(Fspy3-2015020);佛山市十三五医学重点专科和特色专科建设(FSZDZK135024);佛山市卫生和计划生育局医学科研课题项目(20180099)

摘　　要：目的探讨Ⅰ期心脏康复对急性ST段抬高型心肌梗死(STEMI)急诊经皮冠状动脉介入治疗(PCI)后患者心功能的影响。方法连续入选2017年1月至2018年5月于佛山市第二人民医院CCU收治的78例STEMI患者,随机分为观察组38例和对照组40例,观察组实施Ⅰ期心脏康复训练,对照组给予传统的急性心肌梗死PCI后常规护理。结果两组患者住院期间干预后,观察组左心室每搏做功、心输出量及6分钟步行试验距离较对照组均显著增加(P均<0.05),两组患者平均动脉压、主要心血管不良事件(严重心律失常、梗死后心绞痛、心力衰竭)及术口血肿发生率比较,差异均无统计学意义(P均>0.05)。结论对急性ST段抬高型心肌梗死急诊PCI后患者实施Ⅰ期心脏康复能改善心功能,提高运动耐力,且安全可行。Objective To discuss the influence of phase I cardiac rehabilitation on heart function in patients with acute ST-segment elevation myocardial infarction(STEMI)after emergent PCI.Methods STEMI patients(n=78)were chosen continuously from CCU of the Second People’s Hospital of Foshan City from Jan.2017 to May 2018,and divided randomly into observation group(n=38)and control group(n=40).The observation group was given phase I cardiac rehabilitation and control group was given traditional routine nursing for acute myocardial infarction(AMI)after PCI.Results After the intervention during hospitalization,the levels of left ventricular strove work,cardiac output(CO)and 6-minute walk distance(6MWD)increased significantly in observation group compared with control group(all P<0.05).The comparison in the level of mean arterial pressure(MAP)and incidence of major adverse cardiovascular events(MACE,including severe arrhythmia,post-infarction angina pectoris and heart failure)and hematoma around wound between 2 groups showed the difference had no statistical significance(all P>0.05).Conclusion The implement of phase I cardiac rehabilitation can improve heart function,promote exercise tolerance and is safe and feasibility in STEMI patients after emergent PCI.

关 键 词：Ⅰ期心脏康复 急诊PCI 急性心肌梗死 心功能 运动耐力 

分 类 号：R542.22[医药卫生—心血管疾病]