老年冠心病心衰患者运动康复治疗中心理干预的临床意义

Clinical implication of psychotherapy on elderly patients with coronary heart failure undergoing rehabilitation

目的探讨老年冠心病心衰患者运动康复治疗中的心理干预作用。方法 82例老年冠心病心衰患者随机分为对照组和心理干预组,均给予正规的心衰药物治疗及专业康复运动训练,干预组同时接受正规的心理治疗。采用HAMD、HAMA进行评定,监测血压、心率、血糖、血脂、左室射血分数(LVEF)及6 min步行距离等,于治疗4周及6个月后分别予以评定。结果入组时两组肯定抑郁者为53例(64.6%),肯定焦虑者为36例(43.9%);4周及6个月后干预组HAMD评分均低于对照组(P<0.05);4周后两组患者的心率、血脂、6 min步行距离以及LVEF较治疗前均显著改善;6个月后干预组上述指标改善更为明显,与对照组比较有统计学差异。结论心理治疗能有效改善老年冠心病心衰患者运动康复治疗中的负性情绪,改善心功能。

Objective To investigate the psychological status of elderly patients with coronary heart failure who under-went rehabilitation therapy and psychological intervention.Methods A total of 82 hospitalized elderly patients with coronary heart disease were randomly divided into two groups：the intervention group and control group.All patients re-ceived drug therapy for heart failure and rehabilitation exercise training under the guidance of rehabilitation therapist. The patients in the intervention group also received psychological treatments.HAMD and HAMA scores were evalua-ted.Blood pressure, heart rate, blood glucose and lipid profiles, left ventricular ejection factor （ LVEF） and 6-minute walking distance were monitored at the baseline, 4 weeks and 6 months after treatments, respectively.Results There were 53 depression cases （64.6%） and 36 anxiety cases （43.9%） in the two groups.After 4 weeks and 6 months of treatments, the HAMD scores of the intervention group were significantly lower than those of the control group （ all P＆lt;0.05）.Six-minute walking distance of the intervention group was significantly longer than that of the control group after 4 weeks of treatment.Blood pressure, heart rate, lipid profiles, 6-minute walking distance and cardiac function were improved markedly in the intervention group than in the control group after 6 months of treatment.Conclusion Psy-chological therapy can effectively correct the negative emotion and improve heart function of elderly patients with coro-nary heart failure undergoing rehabilitation therapy.