老年急性心肌梗死患者急诊介入术后早期程序康复研究

The study of early rehabilitation programme in old-age patients with acute myocardial infarction after emergent intervention

目的对老年急性心肌梗死患者在接受直接经皮冠脉介入(PCI)治疗并予早期程序康复治疗后在住院期间及一年随访的病情作出评估。方法166例AMI患者经PCI治疗后随机分为:康复组予早期心脏程序康复治疗;对照组予传统康复治疗。两组主要基线资料具可比性,住院1周后及随访1年后均行心脏彩色多普勒二维超声心动图检查,并收集患者所出现的并发症。结果两组左室舒张末内径、左室收缩末内径、左室后壁厚度及左室射血分数对比在统计学上均无显著性差异(P>0.05);两组所出现的并发症:心律失常、心绞痛及死亡率均无显著性差异(P>0.05);而院内感染,对照组明显多于康复组(P<0.05)。结论老年AMI患者急诊PCI后早期心脏程序康复治疗有益、安全、可行,且能明显减少院内感染的发病率,缩短住院时间,减轻患者经济负担。

Objective To evaluate the change of condition in the hospitalization period and one year of follow up in patients with acute myocardial infarction after emergent intervention and carrying out early rehabilitation programme . Methods 166 cases with AMI after PCI were randomly divided into two groups with matched clinical data, early rehabilitation programme group who administered early rehabilitation treatment and control group who administered traditional rehabilitation therapy, all the patients performed color doppler echocardiogram after 1 week and one year of follow up, to compare the incidence rate of complications. Results There was not significant differences in left ventricular diastolic diameter and left ventricular systolic diameter and left ventricular posterior wall thickness , left ventricular ejection fraction and the complications of arrhythmia, angina, mortality （ P 〉 0.05 ）, the incidence rate of nosoeomial Infection in control group was significant higher than that in rehabilitation programme group（ P 〈 0. 05 ）. Conclusion Early rehabilitation programme in old-age patients with acute myocardial infarction after emergent intervention can significantly reduce incidence rate of nosocomial infection and shorten the inhospitalization , lighten patients＂ economic burden, it has the availability and safety and feasibility.