基于双心医学模式的运动康复对冠心病患者PCI术后的影响

Influence of exercise rehabilitation based on psycho-cardiology medical model on patients with coronary heart disease after PCI

目的:研究基于双心医学模式的运动康复对冠心病患者经皮冠状动脉介入治疗(PCI)术后的影响。方法:于我院行PCI术的164例冠心病患者被随机均分为常规护理组与运动康复组(常规护理组基础上给予基于双心医学模式的运动康复),两组均干预6个月。比较两组一般临床资料、躯体化症状自评量表(SSS)评分,心功能指标:LVEF、LVEDV,6 min步行距离(6MWD)及健康状况调查简表(SF-36)评分。结果:随访过程中,常规护理组失访3例,运动康复组失访2例、终止随访4例。与常规护理组比较,干预6个月后,运动康复组SSS评分[(33.97±5.76)分比(25.76±4.79)分]、LVEDV[(125.33±16.14)ml比(119.53±16.82)ml]均显著降低,LVEF[(56.28±4.46)%比(59.28±4.90)%]、6MWD[(410.42±20.08)m比(439.69±20.66)m]及SF-36躯体功能[(19.20±4.22)分比(23.76±3.98)分]、肌体疼痛[(7.42±1.99)分比(8.84±1.94)分]、一般健康状况[(16.42±4.73)分比(19.09±4.37)分]、活力[16.0(7.0)分比19.0(6.8)分]、情感角色[(4.86±1.10)分比(5.18±0.86)分]、心理健康评分[20.0(5.0)分比24.0(8.8)分]均显著升高(P<0.05或<0.01)。结论:基于双心医学模式的运动康复可显著改善冠心病患者PCI术后心功能及心理状况,提高生活质量。

Objective:To study influence of exercise rehabilitation based on psycho-cardiology medical model on patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI).Methods:A total of 164 CHD patients undergoing PCI in our hospital were randomly and equally divided into routine nursing group and exercise rehabilitation group(received exercise rehabilitation based on psycho-cardiology medical model based on routine nursing group).Both groups were intervened for six months.General clinical data,score of somatic symptoms scale(SSS),cardiac function indexes:LVEF and LVEDV,6min walking distance(6MWD)and score of 36-item short-form heath survey(SF-36)were compared between two groups.Results:During follow-up,there were three cases lost in routine nursing group,and two cases lost and four cases stopped follow-up in exercise rehabilitation group.Compared with routine nursing group,six months after intervention,there were significant reductions in SSS score[(33.97±5.76)scores vs.(25.76±4.79)scores]and LVEDV[(125.33±16.14)ml vs.(119.53±16.82)ml],and significant rise in LVEF[(56.28±4.46)%vs.(59.28±4.90)%],6MWD[(410.42±20.08)m vs.(439.69±20.66)m],scores of physical functioning[(19.20±4.22)scores vs.(23.76±3.98)scores],bodily pain[(7.42±1.99)scores vs.(8.84±1.94)scores],general health[(16.42±4.73)scores vs.(19.09±4.37)scores],vitality[16.0(7.0)scores vs.19.0(6.8)scores],role-emotional[(4.86±1.10)scores vs.(5.18±0.86)scores],mental health[20.0(5.0)scores vs.24.0(8.8)scores]of SF-36 in exercise rehabilitation group(P<0.05 or<0.01).Conclusion:Exercise rehabilitation based on psycho-cardiology medical model can significantly improve cardiac function and psychological status,and improve quality of life in patients with coronary heart disease after PCI.