永久起搏器植入术后早期功能锻炼的临床研究

Clinical study of early exercise after permanent pacemaker implantation

目的评价永久起搏器植入术后早期功能锻炼的临床疗效。方法入选病例随机分为康复组和对照组。康复组患者术后按照设计的8天循序渐进的方案进行功能锻炼,出院后按上述方案序贯锻炼。而对照组患者术后按常规宣教。手术后1,2,3个月进行随访,观察起搏器术后患者有无术侧肩部疼痛和功能障碍。结果总共入选117例起搏器术后患者,其中康复组62例,对照组55例。康复组术后1个月随访时有6例出现肩部疼痛,其中2例出现肩关节活动障碍;术后3个月时只有1例术侧肩部轻微疼痛。对照组在术后1个月随访时有16例出现肩部疼痛,其中5例伴有肩关节活动障碍;术后3个月时还有3例肩部轻微疼痛。两组患者随访期内均未发生电极脱位、伤口延迟愈合、囊袋迟发性出血等并发症。结论起搏器术后患者早期功能锻炼可降低术后发生肩部疼痛及活动障碍的发生率,且不会增加电极脱位等并发症的风险。

Objective To evaluate clinical efficacy of early exercise after permanent pacemaker implantation. Methods Patients were randomly divided into exercise group and control group. The control group received standard instructions, whereas the exercise group was instructed on exercises in accordance with 8-day plan after pacemaker implantation. All patients were followed up for 3 months. Symptoms such as shoulder pain and mobility were observed in followed-up period. Results A total of 117 cases were selected after pacemaker implantation, which 62 patients of exercise group and 55 cases of control group. One month after implantation, 5 cases of exercise group reported shoulder pain, including 2 cases had shoulder mobility; and only 1 case had mild shoulder pain after three months. In the control group, 16 patients complained of shoulder pain, of them 6 cases had shoulder mobility after one month, and 3 cases had mild pain after three months. Postoperative complications such as electrode dislocation, delayed healing, delayed pocket hemorrhage did not occur in all patients. Conclusions Early exercise can reduce the incidence of shoulder pain and shoulder mobility after pacemaker implantation, and don＇t increase the risk of postoperative complications.