心脏瓣膜术后患者Ⅰ期心脏运动康复的疗效研究  

Study on the Curative Effect of PhaseⅠCardiac Exercise Rehabilitation in Patients After Cardiac Valve Operation

作　　者：何正坤[1] 裴海燕 庄嘉伟 郭宏伟[1] HE Zhengkun;PEI Haiyan;ZHUANG Jiawei;GUO Hongwei(Department of Cardiac Surgery,the First Affiliated Hospital of Xiamen University,Xiamen Fujian 361001,China)

机构地区：[1]厦门大学附属第一医院心脏外科,福建厦门361001

出　　处：《中国卫生标准管理》2023年第6期100-104,共5页China Health Standard Management

基　　金：第五轮福建省卫生教育联合攻关计划项目(2019-WJ-36)。

摘　　要：目的观察心脏瓣膜术后患者Ⅰ期心脏运动康复的疗效。方法选取2019年11月—2020年11月就诊于福建省厦门市某三级甲等医院入住心脏外科并在全麻体外循环下行心脏瓣膜手术患者120例,按照随机数字表法分为对照组与干预组,各60例。对照组给予常规康复干预,干预组在常规康复干预的基础上采用Ⅰ期心脏运动康复方案。比较两组患者术前1 d和出院当天的6 min步行试验(6 minutes walk test,6MWT)距离以及相应的自觉用力程度分级、心功能及并发症、二次入ICU发生率及二次入院发生率。结果对照组与干预组术前1 d 6MWT距离、自觉用力程度分级(Borg评分)对比差异无统计学意义(P>0.05),临床对比无统计学价值;出院当天干预组6MWT距离显著长于对照组,Borg评分显著低于对照组,差异有统计学意义(P<0.05),临床对比有统计学价值。干预前两组左心室舒张末期内径(left ventricular end diastolic diameter,LVEDD)、左心室收缩末期内径(Left ventricular end systolic diameter,LVESD)、左室射血分数(left ventricular ejection fraction,LVEF)、脑钠肽(brain batriuretic peptide,BNP)差异均无统计学意义(P>0.05)。干预后,干预组LVEDD、LVESD、LVEF、BNP显著优于对照组,差异有统计学意义(P<0.05),临床对比有统计学价值。干预组并发症发生率、二次入ICU及二次入院发生率均显著低于对照组,差异有统计学意义(P<0.05)。结论心脏瓣膜术后患者Ⅰ期心脏运动康复方法,能够提高患者运动耐力,促进其心脏功能康复,降低自觉用力程度及并发症、二次入ICU及二次入院发生率,促使患者更早地回归生活与社会。Objective To observe the curative effect of phaseⅠcardiac exercise rehabilitation for patients after heart valve operation.Methods From November 2019 to November 2020,a total of 120 patients who were admitted to cardiac surgery in a third-class A hospital in Xiamen,Fujian Province and underwent cardiac valve surgery under general anesthesia and cardiopulmonary bypass were randomly divided into control group and intervention group with 60 cases in each group.The control group was given routine rehabilitation intervention,and the intervention group was given phase I cardiac exercise rehabilitation program on the basis of routine rehabilitation intervention.The distance of 6 min walking test,the degree of conscious exertion,cardiac function and complications,the incidence of re-admission to ICU and the incidence of re-admission were compared between the two groups.Results There was no significant difference in the distance of 6 minutes walk test(6MWT)and Borg score between the control group and the intervention group one day before operation(P>0.05),and the clinical comparison had no statistical value.On the day of discharge,the distance of 6MWT in the intervention group was significantly longer than that in the control group,and Borg score was significantly lower than that in the control group(P<0.05).The clinical comparison has statistical value.The first two groups were treated with left ventricular end diabetic diameter(LVEDD),left ventricular end systemic diameter(LVESD),left ventricular injection fraction(LVEF)and brain natural peptide(BNP)were not statistically significant(P>0.05).After the intervention,LVEDD,LVEF and BNP in the intervention group were significantly better than those in the control group,with significant differences(P<0.05)The incidence of complications,second admission to ICU and second admission in the intervention group were significantly lower than those in the control group(P<0.05).Conclusion Phase I cardiac exercise rehabilitation method for patients after heart valve surgery can impr

关 键 词：运动康复 早期活动 Ⅰ期心脏运动康复 心脏瓣膜术后 疗效 观察 

分 类 号：R631[医药卫生—外科学]