基于无创心输出量监测的冠状动脉旁路移植术后早期运动康复的临床疗效分析  

The effect of early rehabilitation based on noninvasive cardiac output measurement after coronary artery bypass grafting

作　　者：李颖[1] 陶凉[1] 肖红艳[1] 龚臣 祝蔚然 LI Ying;TAO Liang;XIAO Hong-yan;GONG Chen;ZHU Wei-ran(Cardiac Rehabilitation Center,Wuhan Asia Heart Hospital,Wuhan 430000,China)

机构地区：[1]武汉亚洲心脏病医院心脏康复中心,湖北省武汉市430000

出　　处：《中国心血管病研究》2020年第10期915-919,共5页Chinese Journal of Cardiovascular Research

基　　金：2019年武汉市卫健委面上科研项目(WX19D50)。

摘　　要：目的观察基于无创心输出量监测的早期运动康复对冠状动脉旁路移植术(CABG)患者的临床疗效.方法选取2019年4月至2020年4月于武汉亚洲心脏病医院行CABG的患者206例,应用随机数字表将患者随机分为对照组和康复组,两组均予以CABG常规治疗和护理,康复组给予早期运动康复治疗.康复组又随机分为常规康复亚组和精准康复亚组.其中常规康复亚组通过监测心率、血压控制运动强度和风险;精准康复亚组通过监测心率、血压、无创心输出量控制运动强度和风险.结果出院前,康复组Barthel指数、6min步行试验距离(6MWD)均明显高于对照组[Barthel指数:74.66±10.27比70.89±13.60;6MWD:(29423±86.87)m比(263.33±77.71)m,P<0.05].康复组住ICU时间明显低于对照组[(37.43±31.00)h比(48.31±65.23)h,P<0.05].常规康复亚组4例患者发生低血压,精准康复亚组无患者发生低血压,精准康复亚组低血压的发生率低于常规康复亚组(P<0.05).结论围术期实施早期运动康复可以提高CABG患者出院前的日常生活能力和运动能力,缩短住ICU时间.基于无创心输出量监测的早期运动康复能提高运动康复的安全性.Objective To evaluate the ffeets of early cardiac rehabilitation based on non-invasive cardiac output measurement on the patients after coronary artery bypass grafting(CABG).Methods 206 CABG patients(2019.4-2020.4)in Wuhan Asia Heart hospital were randomly divided into control group and rchabilitation group by random number table.Both groups were given routine care of CABG.Patients in the rehabilitation group received early rehabilitation from the first day after surgery.The rehabilitation group was randomly divided into conventional rehabilitation subgroup and precision rehabilitation subgroup.In the conventional rehabilitation subgroup.exercise intensity and risk were controlled by monitoring heart rate and blood pressure.In the precision rehabilitation subgroup exercise intensity and risk were controlled by monitoring heart rate,blood pressure and noninvasive cardiac output.Results The Barthel index and 6 minutes walking distance(6MWD)of the rehabilitation group before discharge were significantly higher than those of the control group[Barthel index:74.66410.27 vs.70.89+13.60;6MWD:(294.73+86.87)m vs.(2633377.71)m,P<0.05].The length of ICU stay of the rehabilitation group was lower than that of the control group[(37.43+31.00)h vs.(48.31+65.23)h,P<0.05].Four patients in the conventional rehbilitation subgroup had hypotension,while none in the precision rehabilitation subgroup had hypotension.The incidence of hypotension in the precision rehabilitation subgroup was lower than that in the conventional rehabilitation subgroup.Conclusion Early cxercise rchabilitation in perioperative period can improve the daily life and exercise ability of CABG patients before discharge and shorten the ICU stay,Early exercise rehabiliation based on non-invasive cardiac output monitoring can improve the safety of exercise rehabilitation.

关 键 词：冠状动脉旁路移植 心脏康复 无创心输出量监测 

分 类 号：R473[医药卫生—护理学] R654.2[医药卫生—临床医学]