早期心脏康复训练对经皮冠状动脉介入治疗术后功能性体适能指标的影响

The effect of early cardiac rehabilitation training on functional fitness indexes after percutaneous coronary intervention

目的探讨早期心脏康复训练对经皮冠状动脉介入治疗(PCI)术后冠心病患者功能性体适能指标的影响。方法选取2019年1月至2020年1月于我院择期行PCI术的冠心病患者90例,采用随机数字表法分为对照组和研究组各45例。两组均给予常规药物治疗,在此基础上,对照组实施简单心脏康复治疗,研究组实施早期新型心脏康复训练。比较两组心功能指标、运动耐量、功能性体适能指标、自我效能评分及不良反应发生情况。结果训练后研究组左心室射血分数显著高于对照组,左心室后壁厚度及左心室舒张末期内径均显著低于对照组(P<0.05)。训练后研究组达到运动终点时间、6 min内最大步行距离显著高于对照组,最大心率、终点ST段压低>1 mm比例显著低于对照组;上肢肌力、下肢肌力及有氧耐力显著高于对照组,上肢柔韧性、下肢柔韧性、灵活性/平衡性显著低于对照组;角色功能、症状管理、情绪控制、沟通能力及自我效能总分均显著高于对照组,差异均有统计学意义(P<0.05)。两组训练期间不良反应发生率比较差异无统计学意义(P>0.05)。结论PCI术后实施早期心脏康复训练的安全性可靠,能改善冠心病患者心功能,增强功能性体适能、运动耐量和自我效能,值得临床推广使用。

Objective To investigate the effect of earlycardiac rehabilitation training on functional fitness indexes of patients after percutaneous coronary intervention(PCI)for coronary heart disease.Methods Ninety patients with coronary heart disease who underwent elective PCI in our hospital from January 2019 to January 2020 were selected.The patients were divided into a control group and a study group by random number table method,45 in each group.Both groups were treated with conventional drugs.On this basis,the control group was treated with simple cardiac rehabilitation while the study group was trained with early new cardiac rehabilitation.The cardiac function index,exercise tolerance,functional fitness index,self-efficacy score and adverse reactions were compared between the two groups.Results After training,the left ventricular ejection fraction was significantly higher and the thickness of the posterior wall of the left ventricle and the end-diastolic diameter of the left ventricle in the study group were significantly lower than those of the control group(P<0.05).After training,the time to reach the end point of exercise and the maximum walking distance within 6 minutes of the study group were significantly higher than those of the control group,and the maximum heart rate and the ratio of ST segment depression at the end point>1 mm were significantly lower than those of the control group.After training,the upper limb muscle strength,lower limb muscle strength and aerobic endurance of the study group were significantly higher than those of the control group.Flexibility,lower limb flexibility,and flexibility/balance in the study group were significantly lower than those in the control group.After training,role function,symptom management,emotion control,communication ability and total score of self-efficacy in the study group were significantly higher than those in the control group.All differences were statistically significant(P<0.05).There was no significant difference in incidence of advance reaction during training between the two groups(P>0.05).Conclusion The earlycardiac rehabilitation training after PCI is safe and reliable.It can improve the cardiac function,enhance the functional physical fitness,exercise tolerance and self-efficacy in these patients.It is worthy of clinical application.