急性心肌梗死患者行冠状动脉介入术后即刻康复训练的效果研究

Effects of immediate exercise training after radial artery coronary intervention in patients with acute myocardial infarction

目的探讨急性心肌梗死患者急诊经桡动脉行冠状动脉介入术后即刻康复训练对临床疗效的影响。方法选择120例急性心肌梗死急诊经桡动脉行冠状动脉介入术后的患者,随机分为试验组和对照组,每组各60例。试验组给予术后即刻康复训练的方法,对照组给予常规术后康复训练的方法。比较两组干预前和干预后第7天的日常生活能力、左心室射血分数、住院时间的变化,两组干预后6个月的生活质量和心脏不良事件的发生率,访谈患者的看法,进行全面的效果评价。结果干预1周后,试验组左心室射血分数显著高于对照组(P<0.01);日常生活能力明显高于对照组(P<0.01);试验组的住院时间少于对照组(P<0.01);干预后6个月时,试验组的生活质量高于对照组(P<0.01);心绞痛、心律失常发生率显著低于对照组(P<0.05);两组心力衰竭、冠状动脉再狭窄发生率差异无统计学意义(P>0.05);试验组均对术后即刻康复训练在提高舒适度方面给予了肯定并表示愿意积极配合。结论术后即刻康复训练可改善急性心肌梗死患者急诊行冠状动脉介入术后的左心室射血分数,缩短住院时间,提高生活质量,减少心绞痛、心律失常的发生。

Objective To investigate the effects of immediate exercise training in acute myocardial infarction（MI） patients treated by radial artery coronary intervention. Methods Totally 120 patients with acute MI that received radial artery coronary intervention were randomized into two groups：60 cases in the control group and 60 cases in the experimental group. The experimental group started immediate exercise training right after the radial artery coro- nary intervention.The control group received routine exercise training,which started one week after the radial artery coronary intervention. The Activity of Daily Living Scale （ADL） ,left ventricular ejection fraction（LVEF）,and length of hospital stay were compared in both groups before the intervention and 7 days after the start of the intervention. The patients＇ quality of life and the incidence of adverse cardiac events were investigated 6 months after the inter- vention. Interviews of the patients were conducted to have week after the start of the intervention,the LVEF in the the control group（P〈0.O1 ）,and the ADL was significantly a comprehensive evaluation on the results. Results One experimental group was significantly higher than that in higher in the experimental group（P〈0.01）. The length of hospital stay in the experimental group was shorter than that in the control group （P〈O.O1）. The follow-up results after 6 months showed that the experimental group had better quality of life（P〈0.01 ）,but lower incidence of angina and arrhythmia （P〈0.05）. There were no differences in heart failure and coronary artery in-stent restenosis between two groups （P〉0.05）. Results of the interviews showed that the patients were satisfied with the improved comfort through immediate exercise training and expressed willingness to cooperate. Conclusion Immediate exercise training improved the LVEF in patients with acute myocardial infarction after emergent coronary artery intervention,short- ened the length of hospital stay,improved patients＇ quality of life as well as reduced the incidence of angina and arrhythmia.