图式康复操对永久起搏器植入术后患者康复的效果评价

Evaluation of the effect of patients' rehabilitation with schemata rehabilitation gymnastics after permanent pacemaker implantation

目的引用一套起搏器术后康复操指导患者进行早期功能锻炼,评价其对永久起搏器植入术后患者并发症及日常生活活动能力恢复情况的影响效果。方法将符合纳入标准、住院行永久起搏器植入术的患者作为研究对象。根据计算机产生的随机数字分为干预组和对照组各40例。干预组患者在常规护理和健康宣教的基础上,按照设计的8天循序渐进的康复操方案进行功能锻炼,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方案进行活动和锻炼。观察两组患者术后并发症的发生率,在干预前及肢体功能锻炼8天后分别对两组患者应用改良Barthel指数评定量表(Modified Barthel Index,MBI)来评价患者日常生活活动能力。结果两组患者术后术侧肩痛和肩关节活动障碍的发生率经卡方检验,差异有显著性(P<0.05),干预组患者术后术侧肩痛和肩关节活动障碍的发生率均低于对照组;干预前两组患者MBI评分经检验,无明显差异(P>0.05);肢体功能锻炼8天后干预组MBI评分明显高于对照组,差异有显著性(P<0.05)。结论早期应用标准的肢体康复操锻炼方法进行功能锻炼能有效的预防永久起搏器植入术后术侧肩痛及肩关节活动障碍的发生,能更快促进患者日常生活活动能力的恢复,康复操有图式及注解让患者易于理解和接受,操作方便,值得广泛推广。

【Objective】 To carry out early functional exercises according to a set of rehabilitation gymnastics, and to evaluate the effect of postoperative complications and recovery of activities of daily living in patients after permanent pacemaker implantation. 【Methods】 The patients meeting the inclusion criteria and implanted with a permanent pacemaker in hospital were researched. They were divided into the intervention group and the control group according to the computer-generated random numbers. Compared to patients in the control group, the patients in the intervention group were additionally taught to carry out early functional exercises according to the designed 8-day rehabilitation gymnastics on the basis of the usual care and health education. The incidence of postoperative complications were observed and patients＇ activities of daily living before and after the intervention were researched between the two groups using Modified Barthel Index Rating Scale（MBI）.【Results】 The incidence of shoulder pain and limb movement disorder in patients in the control group was higher than those in the intervention group（the difference was statistically significant, P 0.05）. The scores of the scale before the intervention were not significantly different（P 0.05）. But the scores in the intervention group were significantly higher than those in the control group after 8-day functional exercises, the difference was statistically significant（P 0.05）.【Conclusion】 It contributes to prevent shoulder pain and shoulder movement disorder effectively and promote activities of daily living in patients according to the application of early standard physical rehabilitation exercises after permanent pacemaker implantation. The rehabilitation gymnastics should be popularized because it is easy to grasp.