院内Ⅰ期心脏康复体操对急性心肌梗死术后患者心肺功能及预后的影响研究  

Effect of in-hospitalⅠ-phase cardiac rehabilitation exercises on cardiopulmonary function and prognosis of patients with acute myocardial infarction after percutaneous coronary intervention

作　　者：施海燕[1] 费萍燕 顾品花 Shi Haiyan;Fei Pingyan;Gu Pinhua(Songjiang Hospital Affiliated to Shanghai Jiaotong University,Shanghai 201600,China)

机构地区：[1]上海交通大学附属松江医院(筹)/上海市松江区中心医院,上海201600

出　　处：《中国康复》2022年第7期414-418,共5页Chinese Journal of Rehabilitation

摘　　要：目的:探讨院内Ⅰ期心脏康复体操对急性心肌梗死患者经皮冠状动脉介入治疗(PCI)后心肺功能及预后的影响。方法:选取接受PCI治疗的急性心肌梗死(AMI)患者84例为研究对象,采用随机抽签法分为对照组及康复组,每组42例。对照组实施常规治疗与护理,康复组在对照组基础上实施Ⅰ期心脏康复体操治疗;记录2组患者院内康复训练前后静息心率、静息收缩压、静息舒张压及指脉氧指标,采用心脏超声、6min步行试验、心肺运动试验及简明健康调查问卷(SF-36)比较2组患者心功能指标、心肺功能及生活质量指标,并随访出院后1年内是否发生MACE事件。结果:院内康复后康复组患者静息心率、静息收缩压低于对照组(P<0.05)。术后6个月2组患者LVEF均较康复前提高(P<0.05),且康复组更高于对照组(P<0.01)。出院前及术后6个月,康复组患者6min步行距离均显著高于对照组(P<0.01);术后6个月,康复组患者peak VO_(2)、peak-METs、AT、O_(2) pulse均高于对照组(P<0.05)。术后6个月2组患者SF-36各维度评分均较治疗前升高(P<0.05),且康复组显著高于对照组(P<0.05)。1年随访结果显示康复组患者MACE事件发生率低于对照组,但无统计学差异。结论:院内Ⅰ期心脏康复体操能够改善急性心肌梗死患者PCI术后心肺功能,有效提高患者的运动耐力及生活质量,且安全可行。Objective:To explore the effect of in-hospital phase I cardiac rehabilitation exercises on the cardiopulmonary function and prognosis of patients with acute myocardial infarction after percutaneous coronary intervention(PCI).Methods:A total of 84 patients with acute myocardial infarction(AMI)who underwent PCI in the Department of Cardiology,Songjiang District Central Hospital from September 2019 to September 2020 were selected as the research objects.They were divided into the control group and the rehabilitation group by random drawing,with 42 cases in each group.The control group received conventional treatment and nursing care,and the rehabilitation group performed phase I cardiac rehabilitation gymnastics treatment on the basis of the control group.The resting heart rate,resting systolic blood pressure,resting diastolic blood pressure and finger end oxygen indexes of the two groups were recorded before and after in-hospital rehabilitation training,the cardiac function of the two groups was compared using echocardiography,6-min walk test,cardiopulmonary exercise test,and brief health questionnaire(SF-36)indicators,cardiopulmonary function and quality of life indicators.The MACE event was followed up within 1 year after discharge.Results:After treatment,the left verdricular ejection fraction(LVEF)of the two groups was improved as compared with that before treatment(P<0.05),and the improvement of the rehabilitation group was more significant than that in the control group.After in-hospital rehabilitation,the resting heart rate and resting systolic blood pressure in the rehabilitation group were lower than those in the control group(P<0.05).At 6th month after operation,the LVEF in the two groups was improved as compared with that before treatment(P<0.05),and the improvement in the rehabilitation group was more significant than that in the control group.Before discharge and at 6th month after operation,the 6-min walking distance in the rehabilitation group was significantly longer than that in the control group,an

关 键 词：经皮冠状动脉介入 早期心脏康复 心肺功能 生活质量 

分 类 号：R49[医药卫生—康复医学] R542.22[医药卫生—临床医学]