基于HAPA理论的阶段性干预在冠心病PCI术后康复患者中的应用  

Application of staged intervention based on HAPA theory in the rehabilitation of patients with coronary heart disease after PCI

作　　者：赵毅[1] 蔡丹霞[1] 郭燕[1] 陈士芳[1] ZHAO Yi;CAI Dan-xia;GUO Yan;CHEN Shi-fang(Department of Cardiology,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,Henan,CHINA)

机构地区：[1]河南科技大学第一附属医院心内科,河南洛阳471003

出　　处：《海南医学》2024年第11期1663-1668,共6页Hainan Medical Journal

基　　金：2023年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20230463)。

摘　　要：目的探讨基于健康行动过程取向(HAPA)理论的阶段性干预在中青年冠心病经皮冠状动脉介入(PCI)术后康复患者中的应用效果。方法选取2022年10月至2023年3月河南科技大学第一附属医院收治的102例中青年冠心病PCI术后患者纳入研究,按随机数表法分为常规干预组和HAPA干预组各51例。两组患者均接受PCI手术治疗,常规干预组患者PCI术后采取常规干预,HAPA干预组患者在常规干预基础上实施基于HAPA理论的阶段性干预。干预前、干预3个月和6个月后比较两组患者的自我管理能力(CSMS)、健康行为,术后24 h内、干预3个月和6个月后比较两组患者的心功能[左室收缩末径(LVESD)、左室射血分数(LVEF)、左室舒张末径(LVEDD)]、运动耐力[无氧阈耗氧量(VO_(2)AT)、峰值耗氧量(VO_(2)peak)、6 min步行试验(6 MWT)]、日常生活能力(ADL),并比较两组患者的主要不良心血管事件(MACE)。结果干预3个月和6个月后,HAPA干预组患者的CSMS评分、健康行为评分分别为(83.16±10.48)分、(87.04±4.96)分和(54.98±7.98)分、(60.75±6.45)分,明显高于常规干预组的(73.72±11.25)分、(75.10±6.74)分和(50.80±6.79)分、(56.79±7.38)分,差异均有统计学意义(P<0.05);干预3个月和6个月后,HAPA干预组患者的LVEF水平明显高于常规干预组,LVEDD、LVESD水平明显低于常规干预组,差异均有统计学意义(P<0.05);干预3个月和6个月后,HAPA干预组患者的VO2AT、VO2peak、6MWT明显高(长)于常规干预组,差异均有统计学意义(P<0.05);干预3个月和6个月后,HAPA干预组患者的ADL评分分别为(30.48±3.75)分、(23.84±3.37)分,明显低于常规干预组的(35.64±4.03)分、(29.87±3.46)分,差异均有统计学意义(P<0.05);HAPA干预组患者的MACE发生率为5.88%,略低于常规干预组的15.69%,但差异无统计学意义(P>0.05)。结论基于HAPA理论的阶段性干预能提高中青年PCI术后患者自我管理能力,促使患者形成健康行为,改善�Objective To explore the application effect of staged intervention based on the health action process approach(HAPA)theory in the rehabilitation of young and middle-aged patients with coronary heart disease after percutaneous coronary intervention(PCI).Methods A total of 102 young and middle-aged patients with coronary heart disease undergoing PCI were selected from the First Affiliated Hospital of Henan University of Science and Technology from October 2022 to March 2023 and randomly divided into a conventional intervention group and a HAPA intervention group,with 51 patients in each group.Both groups received PCI surgery.The patients in the conventional intervention group received conventional intervention after PCI,while the patients in the HAPA intervention group received staged intervention based on HAPA theory on the basis of conventional intervention.Before intervention,at 3 months,6 months after intervention,the self-management ability(CSMS)and health behaviors of the two groups were compared.Within 24 hours after surgery,at 3 months,6 months after intervention,the cardiac function[left ventricular end systolic diameter(LVESD),left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD)],exercise tolerance[oxygen consumption at anaerobic threshold(VO_(2)AT),peak oxygen consumption(VO_(2)peak),6-minute walk test(6 MWT)],activity of daily living(ADL),and major adverse cardiovascular events(MACE)were compared between the two groups.Results At 3 months,6 months after intervention,the CSMS scores and health behavior scores of patients in the HAPA intervention group were(83.16±10.48)points,(87.04±4.96)points and(54.98±7.98)points,(60.75±6.45)points,respectively,which were significantly higher than(73.72±11.25)points,(75.10±6.74)points and(50.80±6.79)points,(56.79±7.38)points of the conventional intervention group(P<0.05).After 3 months,6 months of intervention,the LVEF level of patients in the HAPA intervention group was significantly higher than that of the conventional inter

关 键 词：冠心病 中青年 经皮冠状动脉介入术 健康行动过程取向理论 阶段性干预 心功能 自我管理 运动耐力 

分 类 号：R541.4[医药卫生—心血管疾病]