急性心肌梗死PCI术后患者5d心脏康复程序效果研究

Effect of 5d cardiac rehabilitation program on patients with acute myocardial infarction after PCI

目的探讨急性心肌梗死PCI术后患者5 d康复程序的安全性和有效性。方法选择无合并症的急性心肌梗死患者100例,随机分为对照组和观察组各50例,对照组采用1周康复程序,观察组采用自行修订5 d康复程序,比较2组患者心率、血压、心电图ST改变、左室射血分数、平均住院日、平均住院费用、心脏事件发生率、便秘、焦虑、生活质量评分、6 min步行试验距离的差异。结果2组均无死亡及再梗死病例,其中心律失常、心力衰竭、心绞痛发生率及心率、血压、心电图ST段变化差异无统计学意义(P>0.05);焦虑、生活质量评分第1天差异无统计学意义(P>0.05),与对照组比较,观察组出院前差异有统计学意义(P<0.05);2组便秘发生率第1天、出院前差异无统计学意义(P>0.05),第2天差异有统计学意义(P<0.05);左室射血分数、平均住院日、6 min步行距离差异有统计学意义(P<0.05)。结论急性心肌梗死PCI术后患者5 d康复程序安全、可行,能促进患者心功能快速恢复,提高运动耐力和自理能力,缩短住院时间,降低便秘、焦虑发生率,提高生活质量。

Objective To explore the safety and effectiveness of the 5-day rehabilitation program for patients with acute myocardial infarction after PCI.Methods A total of 100 patients with acute myocardial infarction without comorbidities were randomly divided into the control group and the observation group with 50 cases each.The control group adopted a 1-week rehabilitation program,while the observation group underwent a self-revised 5-day rehabilitation program.Heart rate,blood pressure,ECG ST changes,left ventricular ejection fraction,average days and expenses of hospitalization,incidence of cardiac events,constipation,anxiety,quality of life scores,differences in 6-min walk test distance were compared between the two groups.Results There was no death or re-infarction in either group.There was no significant difference in the incidence of arrhythmia,heart failure,angina pectoris,heart rate,blood pressure,and ST segment changes in electrocardiograms(P>0.05),or in anxiety and quality of life scores on the first day(P>0.05).The observation group was significantly different from the control group before discharge(P<0.05).There was no difference in the incidence of constipation between the two groups on the first day or before discharge(P>0.05).The difference on the second day was statistically significant(P<0.05).There was statistically significant difference in left ventricular ejection fraction,average hospital stay,and 6-min walking distance between the two groups(P<0.05).Conclusion The 5-day rehabilitation program for patients with acute myocardial infarction after PCI is safe and feasible.It can promote rapid recovery of cardiac function,enhance exercise endurance and selfcare ability,shorten hospital stay,reduce the incidence of constipation and anxiety,and improve the quality of life.