急性心肌梗死患者实施早期运动康复的疗效

Therapeutic effect of early exercise rehabilitation in patients with acute myocardial infarction

目的:探讨急性心肌梗死(AMI)早期运动康复的效果。方法:选择64例生命体征稳定的AMI患者,随机分为早期运动康复组和常规康复组,每组32例。早期运动康复组在发病24h后由床旁康复师给予早期运动康复指导,常规康复组由同水平资质康复师在其绝对卧床1周后给予其运动康复指导。此外两组接受的其他治疗及护理完全相同。观察并统计两组患者的主要不良心血管事件(MACE)(再梗死、死亡、严重心律失常、梗死后心绞痛、心力衰竭)情况、住院天数和生活自理能力情况,并进行比较分析。结果:出院前早期康复组和常规康复组的并发症发生率(40.63%比43.75%)和生活可自理的患者比例(100%比96.88%)无显著差异(P>0.05),但早期康复组患者的住院天数明显短于常规康复组[(9.23±1.45)d比(15.03±2.53)d,P<0.01]。结论:早期运动康复训练对于生命体征稳定的急性心肌梗死患者能缩短患者的住院天数,而且是安全的。

Objective： To explore the effect of early exercise rehabilitation in patients with acute myocardial infarction （AMI）. Methods： A total of 64 AMI patients with stable vital signs were randomly divided into early exercise rehabilitation group （n = 32） and routine rehabilitation group （n= 32） according to number table method. Early exercise rehabilitation group received early exercise rehabilitation guidance by rehabilitation therapists on first day after onset, while routine rehabilitation group received exercise rehabilitation guidance by rehabilitation therapists of same qualification after one-week absolute bed rest. Besides, the two groups received same therapy and nursing. Incidence of major adverse cardiovascular events （MACE： re-infarction, death, severe arrhythmias, angina pectoris after infarction and heart failure）, hospitalization days and condktion of life self-care ability were observed, compared and analyzed between two groups. Results： Before discharge, there were no significant difference in MACE incidence rate （40.63% vs. 43.75%） and percentages of patients with life self-care ability （100% vs. 96.88%） between early exercise rehabilitation group and routine rehabilitation group, P〉0.05, but length of hospital stay in early rehabilitation group [ （9.23 ±1.45） d] was significantly shorter than that of routine rehabilitation group [ （15.03±2.53） d], P〈0.01. Conclusion： Early exercise rehabilitation training can shorten length of hospital stay and is safe in patients with acute myocardial infarction.