意大利综合康复训练配合心理治疗对冠心病介入治疗术后老年患者的临床预后的影响

The effects of compositive rehabilitation training and psychotherapy on the clinical outcomes of Italian patients with coronary heart disease after percutaneous coronary intervention

目的观察意大利某康复中心冠心病老年患者介入治疗后经综合康复训练配合心理治疗对其预后的影响。方法挑选出22例确诊为冠心病并成功进行了首次PCI的患者。临床上采用常规的药物疗法(口服硝酸酯类、肠溶阿司匹林、转换酶抑制剂等)。患者在院整个治疗过程都有专业的心理医生进行心理指导或治疗。患者并于术后3d开始进行不同阶段、不同运动强度的康复训练。3个疗程(约12周)后,行心电图活动平板运动试验[1]。观察活动平板运动试验运动前、运动中的心率、血压、心电图改变及心绞痛发作情况。结果经康复治疗3个疗程后,患者运动时心率较治疗前有所下降,总康复训练时间有明显延长(P<0.05);治疗后患者活动平板运动试验中运动至心绞痛出现时间比治疗前明显延长(P<0.05或P<0.01)、最大运动耐量明显增加(P<0.05)。结论经过系统综合的康复训练和心理治疗冠心病介入术后患者的运动耐量明显提高,心绞痛等临床症状明显缓解。

Objective Observe the effects of compositive rehabilitation training and psychotherapy on the clinical outcomes of italian patients with coronary heart disease after percutaneous coronary intervention. Methods Choose twenty-two cases of coronary heart disease after percutaneous coronary intervention. The pa- tients were given routine medical treatment, such as Po nitrate esters , enteric coated aspirin , CEI ect. Entire treatment the patients were given the professional psychotherapy. After percutaneous coronary intervention 3 days, the patients started staged rehabilitation training. After 3 staged, observed the patients＇ heart rate, blood pressure, changes in ECG during treadmill exercise, as well as the frequency of any angina episodes. Results The results showed that the treatment prolong total exercise time（ P 〈 0. 05 ）, the incidence of exercise-induced angina, improve their exercise tolerance （ P 〈 0. 05, or 0. 01 ）. The patients＇ heart rate improved. Conchmion C0mpositive rehabilitation training and psychotherapy could significantly relieve angina, increase the exercise tol- erance, improve heart rate, blood pressure and also improve ischemia＇ s ECG manifestations of patients with coro- nary heart disease after percutaneous coronary intervention.