早期呼吸功能训练联合阶段康复计划对心肌梗死PCI再通后病人心肺储备功能的影响  

Effect of Early Respiratory Function Training Combined with Stage Rehabilitation Plan on Cardiopulmonary Reserve in Patients with Myocardial Infarction after PCI Recanalization

作　　者：肖华[1] 赵倩萍 邵晨兰 赵卫卫[1] 李雪 陈婷婷 XIAO Hua;ZHAO Qianping;SHAO Chenlan;ZHAO Weiwei;LI Xue;CHEN Tingting(Deyang People's Hospital,Deyang 618000,Sichuan,China)

机构地区：[1]德阳市人民医院,四川德阳618000

出　　处：《中西医结合心脑血管病杂志》2024年第19期3556-3560,共5页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：2021年德阳市科技计划项目(No.2021SZZ078)。

摘　　要：目的:探讨早期呼吸功能训练联合阶段康复计划对急性心肌梗死(AMI)经皮冠状动脉介入术(PCI)后再通病人心肺功能的影响。方法:采用前瞻性随机临床试验,选取2019年7月—2021年12月经PCI治疗且冠状动脉靶血管再通标准达到心肌梗死溶栓试验(TIMI)3级的AMI病人97例,将病人根据随机数字表法分为联合组(48例)与常规组(49例),联合组采取早期呼吸功能训练联合阶段康复计划实施术后康复,常规组仅采取一般临床康复指导、早期呼吸功能训练。比较两组干预前后心功能指标、心肺运动试验指标、西雅图心绞痛量表(SAQ)评分、6 min步行距离。结果:干预后,联合组左室射血分数(LVEF)大于常规组,左室收缩末期容积(LVESV)、左室舒张末期容积(LVEDV)低于常规组,差异均有统计学意义(P<0.05);干预后,联合组峰值摄氧量(peak VO_(2))、峰值功率(peak WR)、无氧阈(VO_(2)AT)、6 min步行距离大于常规组,差异均有统计学意义(P<0.05);干预后,联合组躯体活动受限程度、治疗的主观满意度、SAQ总分均大于常规组,差异均有统计学意义(P<0.05)。结论:对于PCI术后再通的AMI病人,采用早期呼吸功能训练联合阶段康复计划能更显著地改善心肺功能,提高生存质量。Objective:To investigate the effect of early respiratory function training combined with stage rehabilitation program on cardiopulmonary function in patients with acute myocardial infarction(AMI) who underwent recanalization after percutaneous coronary intervention(PCI).Methods:In this study,a prospective randomized clinical trial was conducted to select 97 AMI patients who received PCI from July 2019 to December 2021 and whose coronary target vessel recanalization standard reached thrombolysis in myocardial infarction(TIMI) level 3.According to the random number table method,the patients were divided into combined group(48 cases) and conventional group(49 cases).The patients in combined group received early respiratory function training combined with stage rehabilitation plan to implement postoperative rehabilitation,and the patients in conventional group only received general clinical rehabilitation guidance and early respiratory function training.The cardiac function index,cardiopulmonary exercise test index,Seattle Angina Rating Scale(SAQ) score,and 6-minute walking distance between the two groups were compared.Results:After intervention,the left ventricular ejection fraction(LVEF) of combined group was higher than that of conventional group,and the left ventricular end-systolic volume(LVESV) and left ventricular end-diastolic volume(LVEDV) were lower than those of conventional group,and the differences were statistically significant(P<0.05).After intervention,the peak oxygen uptake(peak VO_2),peak work rate(peak WR),oxygen consumption of anaerobic threshold value(VO_2AT),and 6-minute walking distance of the combined group were greater than those of the conventional group,and the differences were statistically significant(P<0.05).After the intervention,the degree of physical activity limitation,the satisfaction with disease treatment,and the total score of SAQ in combined group were higher than those in conventional group,and the differences were statistically significant(P<0.05).Conclusion:Early respiratory

关 键 词：急性心肌梗死 经皮冠状动脉介入术 呼吸功能训练 阶段康复 心肺功能 

分 类 号：R542.22[医药卫生—心血管疾病]