早期运动护理程序对老年急性心肌梗死患者急诊冠状动脉介入术后心肺功能的影响

Effects of early exercise nursing program on the exercise cardiopulmonary function in elderly patients with acute myocardial infarction after primary percutaneous coronary intervention

目的 探讨早期运动护理程序对急诊介入术后老年急性心肌梗死（AMI）患者心肺功能的影响.方法 经急诊介入治疗的年龄≥65岁AMI患者57例分为康复组和对照组.实施了早期运动护理程序的干预及心肺运动负荷试验（CPET）和3个月的心脏康复观察,其中康复组患者根据无氧代谢阈值（anerobic threshold,AT）运动处方,进行有氧康复训练;对照组患者不给予运动处方,按白行需要活动.3个月后比较两组患者的心肺功能变化.结果 康复组安全地完成早期运动护理程序.3个月后康复组无氧阈氧耗量从（8.1±3.4）mL·min-1·kg1到（10.1±4.2）mL·min-1·kg-1（P=0.041）,有氧运动负荷能力从（23.3±8.3）J/S到（31.7±4.5）J/S（P=0.027）,峰值氧耗量从（11.6±4.2）mL·min-1·kg-1到（15.2±4.9）mL·min-1·kg-1（P=0.003）及峰值运动负荷能力（53.7±14.9）J/S到（65.8±10.3）J/（P=0.039）,均增加;对照组的无氧阈氧耗量从（7.8±4.1）mL·min-1·kg-1到（7.9±6.7）mL·min-1·kg-1和有氧运动负荷能力从（16.8±6.6）J/S到18.5±7.9）J/S,峰值氧耗量从（11.3±3.9）mL·min-1·kg-1到（12.7±3.1）mL·min-1·kg-1和峰值运动负倚能力从（45.6±14.5）J/S到（50.4±13.1）J/S.增加差异无统计学意义.结论 早期运动护理程序干预老年AMI患者可安全有效保障老年运动康复实施,并改善老年患者的运动心肺功能.

Objective To investigate the effects of early exercise nursing programme on the exercise cardiopulmonary function in elderly patients with acute myocardial infarction （AMI） after primary percutaneous coronary intervention （PCI）. Methods Fifty-seven elderly patients with AMI （1〉 65 years of age） who had undergone successful PCI were assigned to re- habilitation group （n=30） and control group （n=27）. Patients finished cardiopulmonary exercise test （CPET） twice. Only patients in the rehabilitation group were subjected to an early exercise nursing program and followed their individually rehabilitation program based on their anaerobic threshold for 3 months. Results Patients in rehabilitation group safely finished early exercise nurse program. The 02 consumption （8.1＋3.4 v 10.1±4.2 mL·min^-1·kg^-1） （P=0.041） and workload （23.3±8.3 v 31.7±4.5 J/S ） （P =0.027） at AT levels and the 02 consumption （11.6±4.2 v 15.2±4.9mL·min^-1·kg^-1） （P =0.003） and workload （ 53.7±14.9 v 65.8±10.3 J/S ） （P =0.039） at peak levels increased after 3 months in rehabilitation group. The 02 consumption （ 7.8±4.1 v 7.9±6.7 mL·min^-1·kg^-1 ） and workload （ 16.8±6.6 v 18.5±7.9 J/S ） at AT levels and the 02 consumption （11.3±3.9 v 12.7±3.1 mL·min^-1·kg^-1 ） and workload （ 45.6± 14.5 v 50.4± 13.1J/S ） at the peak levels had not obvious changes after 3 months in the control group. Conclusions Early exercise nurse program may safely ensure to finish exercise rehabili- tation program in elderly patients with AMI, and can improve their exercise cardiopulmonary function.