家庭自主式心脏运动康复在PCI术后的疗效及对心肺储备功能的影响

Curative effect of home-based autonomic cardiac exercise rehabilitation and its influence on cardiopulmonary reserve function after PCI

目的探讨家庭自主式心脏运动康复在经皮冠状动脉介入治疗(PCI)术后的疗效及对心肺储备功能的影响。方法选择2021年1月至2023年1月于首都医科大学附属北京胸科医院和首都医科大学附属北京康复医院进行PCI的患者85例,采用随机数表法分为试验组(n=43)和对照组(n=42)。对照组给予术后常规治疗,试验组给予家庭自主式心脏运动康复。比较两组临床康复效果、心储备功能、肺储备功能、心肺功能水平变化及心血管不良事件发生情况。结果试验组患者康复总有效率高于对照组康复总有效率(90.70%vs.73.81%),组间差异有统计学意义(P<0.05),两组患者干预前心储备功能水平相比,差异无统计学意义(P>0.05)。干预后两组患者左室射血分数(LVEF)升高,试验组比对照组升高更为显著(P<0.05),两组患者左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室收缩末期容积(LVESV)及左心室舒张末期容积(LVEDV)降低,其中试验组比对照组降低更为显著(P<0.05),两组患者干预前肺储备功能水平相比,差异无统计学意义(P>0.05)。干预后两组患者用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、FEV1/FVC、最大肺活量(VCmax)及最大通气量(MVV)升高,试验组比对照组升高更显著(P<0.05),两组患者干预前心肺功能水平相比,差异无统计学意义(P>0.05)。干预后两组患者峰值摄氧量、无氧阈值摄氧量升高,试验组比对照组升高更显著(P<0.05),两组患者VE/VCO_(2)slople降低,其中试验组比对照组降低更显著(P<0.05)。试验组患者心血管不良事件发生率4.65%远低于对照组心血管不良事件发生率(19.05%),差异有统计学意义(P<0.05)。结论家庭自主式心脏运动康复在PCI术后具有较好的效果,可有效改善患者心肺储备功能。

Objective To investigate the curative effect of home-based autonomic cardiac exercise rehabilitation and its influence on cardiopulmonary reserve function after percutaneous coronary intervention(PCI).Methods The patients undergone PCI(n=85)were chosen and divided,by using random digital table,into test group(n=43)and control group(n=42)in Beijing Chest Hospital affiliated to Capital Medical University and Beijing Rehabilitation Hospital affiliated to Capital Medical University from Jan.2021 to Jan 2023.The control group was given routine post-operation treatment,and test group was given home-based autonomic cardiac exercise rehabilitation.The clinical rehabilitation effect,heart reserve function,lung reserve function,changes of cardiopulmonary function and occurrence of cardiovascular adverse events were compared between 2 groups.Results The total effective rate of rehabilitation was higher in test group than that in control group(90.70%vs.73.81%,P<0.05).The comparison in heart reserve function before the intervention showed the difference had no statistical significance between 2 groups(P>0.05).After the intervention,left ventricular ejection fraction(LVEF)increased,which was more significant in test group compared with control group(P<0.05),and left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular end-systolic volume(LVESV)and left ventricular end-diastolic volume(LVEDV)decreased,which was more significant in test group compared with control group(P<0.05).The comparison in lung reserve function before the intervention showed the difference had no statistical significance between 2 groups(P>0.05).The levels of forced vital capacity(FVC),1-second forced expiratory volume(FEV1),ration of FEV1 to FVC(FEV1/FVC),maximal vital capacity(VCmax)and maximal voluntary ventilation(MVV)increased in 2 groups after the intervention,which was more significant in test group compared with control group(P<0.05).The comparison in cardiopulmonary reserve function before the intervention showed the difference had no statistical significance between 2 groups(P>0.05).The levels of peak oxygen consumption(VO_(2) peak)and anaerobic threshold oxygen uptake increased,and VE/VCO_(2)slople decreased in 2 groups,which were more significant in test group compared with control group(P<0.05).The incidence rates of cardiovascular adverse events were 4.65%in test group and 19.05%in control group(P<0.05).Conclusion The home-based autonomic cardiac exercise rehabilitation has higher effect after PCI,and can effectively improve patients’cardiopulmonary reserve function.