不同时长床旁被动踏车运动对重症脑卒中患者心脏血流动力学的影响  

Effects of bedside passive treadmill exercise with different durations on cardiac

作　　者：陈赛赛 娅茹 黄昊 林万隆 孟琼 CHEN Saisai;YA Ru;HUANG Hao;LIN Wanlong;MENG Qiong(Department of Rehabilitation for Critically Ill Patients,Shanghai Third Rehabilitation Hospital,Shanghai 200436,China)

机构地区：[1]上海市第三康复医院重症康复科,200436

出　　处：《国际心血管病杂志》2023年第2期113-116,共4页International Journal of Cardiovascular Disease

基　　金：上海市卫生健康委员会(202040035)。

摘　　要：目的:观察不同时长床旁被动踏车运动对重症脑卒中患者心脏血流动力学的影响。方法:选取上海市第三康复医院重症脑卒中患者60例,随机分为3组,各20例,分别进行30、60、90 min床旁被动踏车运动。每组运动前后采用无创血压监测仪监测心脏血流动力学变化。结果:与运动前相比,30 min组运动后收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、脉压差(PP)、总外周阻力(TPR)均下降(P均<0.05),心率(HR)、每搏输出量(SV)、心输出量(CO)差异均无统计学意义(P均>0.05);60 min组运动后TPR下降(P<0.05),HR、CO均升高(P均<0.05),SBP、DBP、MAP、PP、SV差异无统计学意义(P均>0.05);90 min组运动后TPR显著下降,SBP、MAP、PP、HR、SV、CO均显著升高(P均<0.05)。90 min组运动后SBP、MAP、PP、HR、SV、CO较30、60 min组均显著升高(P均<0.05)。结论:30 min床旁被动踏车运动主要降压,对心功能影响小;60 min床旁被动踏车运动只增加HR、CO,对心功能作用有限;90 min床旁被动踏车运动显著增加SBP、HR、SV、CO,有效促进心脏泵血,改善心功能。Objective:To determine the effect of bedside passive treadmill exercise(BPTE)with different durations on cardiac hemodynamics in patients with severe stroke.Methods:Sixty patients with severe stroke in Shanghai Third Rehabilitation Hospital were randomly divided into 3 groups based on BPTE duration of 30,60 and 90 minutes(n=20 in each group).The changes of cardiac hemodynamics were recordedusinga non-invasive blood pressure monitor before and after exercise.Results:Compared tothe measurements before exercise,systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP),pulse pressure(PP)and total peripheral resistance(TPR)were decreased(all P<0.05),but heart rate(HR),stroke volume(SV)and cardiac output(CO)were not significantly changed(all P>0.05)in 30-min BPTE group.In 60-min BPTE group,HR and CO were increased but TPR was decreased(all P<0.05).No significant changes in SBP,DBP,MAP,PP and SV were observed(all P>0.05).In 90-min group,TPR was reduced whereas SBP,MAP,PP,HR,SV,and CO were increased significantly(all P<0.05).In addition,SBP,MAP,PP,HR,SV and CO were significantly higher in 90-min BPTE group than those in 30-min and 60-min BPTE groups(all P<0.05).Conclusions:BPTE with 30 minutes reduces blood pressure and has little effect on cardiac function;BPTE with 30 minutes only increases HR and CO,which has a limited effect on cardiac function;BPTE with longer duration(90 minutes)exerts a beneficial effect on cardiac pumping function with a significant increase in SBP,HR,SV and CO.

关 键 词：床旁被动踏车运动 重症脑卒中 心脏血流动力学 

分 类 号：R743.3[医药卫生—神经病学与精神病学]