心理、睡眠干预措施对慢性心衰患者的康复作用

Rehabilitative effect of psychological and sleep intervention on patients with chronic heart failure

目的:研究心理、睡眠干预对慢性心力衰竭(CHF)患者的康复作用。方法:2015年6月至2016年6月在我院心内科住院的CHF患者110例被随机分为常规治疗组(54例)和心理睡眠干预组(56例,干预组),两组均干预随访4周。比较两组干预前后NYHA心功能分级、汉密尔顿抑郁量表(HAMD)、明尼苏达心力衰竭生活质量量表(MLHFQ)、睡眠状况自评量表(SRSS)得分、LVEF以及18m步行试验耗时。结果:干预后,与常规治疗组比较,干预组NYHA II级比例(33.33%比62.50%)显著升高,III级比例(44.45%比21.43%)显著降低,P均<0.05;4周后,干预组HAMD[(19.22±3.27)分比(17.21±2.75)分]、MLHFQ[(54.44±9.22)分比(47.55±11.22)分]、SRSS评分[(21.34±4.87)分比(19.27±3.25)分]以及18m步行试验耗时[(30.95±2.75)s比(29.75±2.17)s]降低更显著,LVEF[(39.84±4.22)%比(43.18±4.52)%]升高更显著,P<0.05或<0.01。结论:心理、睡眠干预对慢性心力衰竭患者的康复具有积极作用,是此类患者重要的辅助治疗手段,值得推广。

Objective:To study rehabilitative effect of psychological and sleep intervention on patients with chronic heart failure(CHF).Methods:A total of 110 CHF patients who were hospitalized in our department from Jun 2015 to Jun 2016 were randomly divided into routine treatment group(n=54)and psychological and sleep intervention group(n=56,intervention group),both groups were intervened and followed up for four weeks.NYHA cardiac function class,scores of Hamilton rating scale for depression(HAMD),Minnesota living with heart failure questionnaire(MLHFQ)and self-rating scale of sleep(SRSS),LVEF and time of 18m walking test were compared between two groups before and after intervention.Results:Compared with routine treatment group after intervention,there was significant rise in percentage of NYHA class II(33.33%vs.62.50%),and significant reduction in percentage of NYHA class III(44.45%vs.21.43%)in intervention group,P<0.05 both.Compared with routine treatment group on four weeks after intervention,there were significant reductions in scores of HAMD[(19.22±3.27)scores vs.(17.21±2.75)scores],MLHFQ[(54.44±9.22)scores vs.(47.55±11.22)scores],SRSS[(21.34±4.87)scores vs.(19.27±3.25)scores]and time of 18m walking test[(30.95±2.75)s vs.(29.75±2.17)s],and significant rise in LVEF[(39.84±4.22)%vs.(43.18±4.52)%]in intervention group,P<0.05 or<0.01.Conclusion:Psychological and sleep intervention possesses positive effects on rehabilitation in patients with chronic heart failure.It is an important auxiliary therapeutic measure in these patients,which is worth extending.