心脏康复在多支冠状动脉血管病变行部分血运重建术后的疗效与安全性  

Efficacy and safety of cardiac rehabilitation after partial revascularization in multi-vessel coronary artery lesion

作　　者：高扬 栾波[1] 张晓娇 肖美玲 郝文君[1] GAO Yang;LUAN Bo;ZHANG Xiaojiao;XIAO Meiling;HAO Wenjun(Department of Cardiology,Liaoning Provincial People′s Hospital,Shenyang,Liaoning 110016,China;Department of Rehabilitation,Liaoning Provincial People′s Hospital,Shenyang,Liaoning 110016,China)

机构地区：[1]辽宁省人民医院心血管内科,沈阳110016 [2]辽宁省人民医院康复科,沈阳110016

出　　处：《重庆医学》2020年第24期4085-4089,共5页Chongqing medicine

基　　金：辽宁省自然科学基金指导计划(20170540539)。

摘　　要：目的观察心脏康复在多支冠状动脉血管病变行部分血运重建术后的疗效与安全性。方法选择2017年3月至2018年11月该院收治的200例冠状动脉多支病变的冠心病患者,分为完全血运重建组和部分血运重建康复干预组(心脏康复组),每组100例。完全血运重建组患者的主要冠状动脉血管完全处理,心脏康复组患者的主要冠状动脉血管部分处理,术后予以院外心脏康复。两组患者术后均控制冠心病危险因素,给予常规冠心病二级预防及适当健康指导等一般治疗。比较两组患者训练开始前、3个月及1年时的左心室射血分数(LVEF)、6 min步行距离和1年时主要不良事件的发生情况及生活质量评分。结果训练开始前两组患者的LVEF、6 min步行距离差异无统计学意义(P>0.05);3个月时两组患者的LVEF明显增加,差异无统计学意义(P>0.05),而6 min步行距离明显增加,差异有统计学意义(P<0.05);1年时两组患者的LVEF及6 min步行距离进一步增加,且在心脏康复组中的变化更加明显,差异有统计学意义(P<0.05);同组患者的LVEF、6 min步行距离距随时间推移逐渐增加,差异有统计学意义(P<0.05)。训练1年后两组主要不良事件的发生情况差异无统计学意义(P>0.05)。训练开始前两组患者生理及心理总评分差异无统计学意义(P>0.05),1年后两组的生理及心理总评分均有明显增加,差异有统计学意义(P<0.05);且心脏康复组的两项评分的增加较完全血运重建组更明显,差异有统计学意义(P<0.05)。结论心脏康复在多支冠状动脉病变患者行部分血运重建术后是有效并且安全的,可进一步提高患者的心功能、运动耐力和生活质量。Objective To observe the efficacy and safety of cardiac rehabilitation in the patients with coronary heart disease(CHD)undergoing partial revascularization due to coronary artery multi-vessel lesion.Methods A total of 200 CHD patients with coronary artery multi-vessel lesions in this hospital from March 2017 to November 2018 were selected and randomly divided into the complete revascularization group and partial revascularization rehabilitation intervention group(cardiac rehabilitation group),100 cases in each group.The main coronary arterial vessels of the patients in the complete revascularization group were completely treated,while the main coronary vessels in the cardiac rehabilitation group were partially treated,and postoperative cardiac rehabilitation was performed after hospital discharge.The risk factors of CHD in all patients of the two groups were controlled,the CHD conventional secondary prevention and general treatment such as appropriate health guidance were given.LVEF and 6 min walking distance before training,in 3 months and one year after training were measured and compared between the two groups,so did the major adverse events occurrence and quality of life scores in one year after training.Results There was no statistically significant difference in LVEF and 6 min walking distance before training between the two groups(P>0.05).In 3 months,LVEF in the two groups was significantly increased,and there was no statistically significant difference between the two groups(P>0.05),while 6 min walking distance was significantly increased with statistically significant difference(P<0.05).In one year,LVEF and 6 min walking distance in the two groups were further increased,moreover the change in the cardiac rehabilitation group was more obvious,and the difference was statistically significant(P<0.05).And in the same group,LVEF and 6 min walking distance were gradually increased as time went on,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the o

关 键 词：冠心病 心脏康复 左心室射血分数 6 min步行距离 主要不良事件 生活质量评分 

分 类 号：R54[医药卫生—心血管疾病]