早期运动训练对慢性心力衰竭患者心功能及自理能力的影响

Effect of early exercise training on heart function and self-care ability of patients with chronic heart failure

目的观察早期运动训练对慢性心力衰竭（CHF）患者心功能及自理能力的影响,探讨CHF的康复护理模式。方法选取2014年1-6月收治的102例CHF患者作为对照组（实施整体护理）,2014年7-12月收治的103例CHF患者作为训练组（实施早期运动训练）,两组患者均予抗心力衰竭药物治疗。并在治疗前后分别测定两组患者的心率（HR）、射血分数（LVEF）、6 min步行距离（6MWT）;在不同时间点采用改良Barthel指数（BI）量表分别评定两组自理能力;观察两组平均住院天数,评价患者满意度。结果两组患者在治疗前心功能各项指标评分差异无统计学意义（P〉0.05）,治疗后训练组各项评分优于对照组（P〈0.001）;两组患者住院首日BI评分差异无统计学意义（P〉0.05）,住院第7天、出院当天及出院后1个月末BI评分比较差异有统计学意义（P〈0.001）;训练组的平均住院天数少于对照组,患者满意度高于对照组（P〈0.001）。结论早期运动训练可改善CHF患者的心功能,提高自理能力,缩短住院时间,提高患者的满意度,值得推广应用。

Objective To investigate the effects of early exercise training on cardiac function and self-care ability of patients with chronic heart failure（ CHF）,so as to explore rehabilitation nursing model of CHF. Methods 102 cases of CHF admitted to hospital from January to June,2014 were selected as control group（ given overall care）,and 103 cases from July to December,2014 were selected as training group（ given early exercise training）. Both groups were given anti-heart failure drugs. Besides,heart rate（ HR）,left ventricular ejection fraction（ LVEF） and 6-min walk test（ 6MWT） before and after treatment in the two groups were measured,respectively. And modified Barthel Index（ BI） scale was used to assess the selfcare ability of the patients at different time points. In addition,average length of hospital stay were measured,and patient satisfaction were evaluated. Results Difference of scores of cardiac function indexes before treatment was not statistically significant between groups（ P〉0. 05）. After treatment,scores of all indexes of the training group were superior to those of the control group（ P〈0. 001）. The difference between BI scores of the two groups at the first hospitalized day was not statistically significant（ P〉0. 05）,while the difference of BI scores at the seventh day,the discharged day and a month after discharge was statistically significant（ P〈0. 001）. Besides,the average length of hospital stay of the training group was shorter than that of the control group,and patient satisfaction was higher than that of the control group（ P〈0. 001）. Conclusion Early exercise training can improve cardiac function of CHF patients,improve their self-care ability,shorten the length of hospital stay,and increase patient satisfaction. Thus,it is worthy of popularization and application in clinical practice.