Ⅰ期心脏康复运动对急性心肌梗死经皮冠状动脉介入术术后患者的临床效果研究

Clinical effect of phaseⅠcardiac rehabilitation exercise on patients with acute myocardial infarction after percutaneous transluminal coronary intervention

目的探讨Ⅰ期心脏康复运动对急性心肌梗死经皮冠状动脉介入术(PCI)术后患者的临床应用效果。方法通过方便抽样选取84例急性心肌梗死PCI术后患者,采用随机数字表法将其分为观察组与对照组,每组42例。对照组实施常规治疗与护理,观察组在常规治疗与护理基础上实施Ⅰ期心脏康复运动方案,采用心脏超声、6 min步行试验评价心功能、运动耐力,生命质量健康调查量表(SF-12)用以评价生命质量。结果经重复测量方差分析,干预前2组患者心功能、生命质量比较差异无统计学意义(P>0.05);出院前,观察组患者6 min步行距离长于对照组,差异有统计学意义(F值为5.279,P=0.024);出院1个月,2组患者在左室射血分数(F值为8.119,P=0.006)、6 min步行距离(F值为9.829,P=0.002)、生命质量的总体健康(F值为6.905,P=0.010)、生理功能(F值为10.595,P=0.002)、生理职能(F值为11.168,P=0.001)、躯体疼痛(F值为12.548,P=0.001)、精神健康(F值为7.362,P=0.008)和活力(F值为13.692,P<0.001)6个维度差异有统计学意义;出院3个月,2组患者在左室射血分数(F值为11.156,P=0.001)、6 min步行距离(F值为16.554,P<0.001)、生命质量各维度差异均有统计学意义(P<0.05)。结论Ⅰ期心脏康复运动方案能够改善急性心肌梗死PCI术后患者的心功能及生命质量,提高运动耐力。

Objective To explore the clinical effect of phaseⅠcardiac rehabilitation exercise on patients with acute myocardial infarction after percutaneous transluminal coronary intervention(PCI).Methods Convenient sampling method was adopted,totally 84 acute myocardial infarction patients after PCI was randomized into an observation group and control group.Both groups accepted general nursing care.The observation group also accepted the phaseⅠcardiac rehabilitation exercise.Cardiac ultrasonic,the 6-minute walk test were used to evaluate the patients′cardiac function and exercise tolerance,the SF-12 were used to evaluate the quality of life.Results After repeated measurement ANOVA,before the intervention,there was no significant difference in cardiac function and quality of life between the two groups(P>0.05);before discharge,the 6-minute walk distance of the observation group was longer than that of the control group,and the difference was significant(F value was 5.279,P=0.024).At 1 month after discharge,there were significant differences in the LVEF(F value was 8.119,P=0.006)and 6-minute walking distance(F value was 9.829,P=0.002)between the two groups(P<0.05),analysis of the six items of SF-12 including general health(F value was 6.905,P=0.010),physical functioning(F value was 10.595,P=0.002),role physical(F value was 11.168,P=0.001),bodily pain(F value was 12.548,P=0.001),mental health(F value was 7.362,P=0.008)and vitality(F value was 13.692,P<0.001)having shown significant differences between the two groups.At 3 months after discharge,there were significant differences in the LVEF(F value was 11.156,P=0.001),6-minute walk distance(F value was 16.554,P<0.001)and quality of life in all dimensions between the two groups(P<0.05).Conclusion PhaseⅠcardiac rehabilitation exercise can improve cardiac function and the quality of life in patients with acute myocardial infarction undergoing PCI,and enhance the exercise tolerance.