分阶段康复训练对老年冠心病患者心肺功能及自我效能的影响

Influence of phased rehabilitation training on cardiopulmonary function and self-efficacy in elderly patients with coronary heart disease

目的探讨分阶段康复训练对老年冠状动脉粥样硬化性心脏病(冠心病)患者心肺功能及自我效能的影响。方法选择2020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收治老年冠心病患者71例,采用随机数表法分为试验组(n=36)和对照组(n=35)。对照组患者给予常规心脏康复,试验组给予分阶段康复训练。比较两组临床康复效果、心肺功能、自我效能、心理弹性、运动耐力水平变化情况。结果试验组患者康复总有效率明细高于对照组(88.89%vs.68.57%),组间差异具有统计学意义(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),干预后两组患者左室射血分数(LVEF)、无氧阈耗氧量(VO2AT)、最大摄氧量(VO2max)升高,其中试验组升高水平较对照组更为显著(P<0.05)。两组患者最大心率(HRmax)也降低,试验组降低水平更为显著(P<0.05)。干预后两组患者症状管理、依从性管理、日常生活管理、情绪管理、信息管理及自我效能管理均有所提高,试验组升高水平更为显著(P<0.05)。干预后两组患者乐观、自强、坚韧也升高,其中试验组升高水平相较于对照组更为显著(P<0.05)。两组患者干预前运动耐力水平相比,无统计学差异(P>0.05)。干预后两组患者6min步行距离(6MWD)、运动耐量均升高,试验组升高水平相较于对照组更为显著(P<0.05)。结论分阶段康复训练对老年冠心病患者具有较好的效果,可有效改善患者心肺功能和自我效能水平。

Objective To discuss the influence of phased rehabilitation training on cardiopulmonary function and self-efficacy in elderly patients with coronary heart disease(CHD).Methods The elderly patients with CHD(n=71)were chosen from Beijing Chest Hospital and Beijing Rehabilitation Hospital affiliated to Capital Medical University from Jan.2020 to Jan.2023.All patients were divided into test group(n=36)and control group(n=35)by applying random digital table.The control group was given routine cardiac rehabilitation,and test group was given phased rehabilitation training.The clinical rehabilitation effect,cardiopulmonary function,self-efficacy,mental resilience and exercise tolerance changes were compared between 2 groups.Results The total effective rate of rehabilitation was significantly higher in test group than that in control group(88.89%vs.68.57%,P<0.05).The difference in cardiopulmonary function had no statistical significance between 2 groups before the intervention(P>0.05).The levels of left ventricular ejection fraction(LVEF),anaerobic threshold oxygen consumption(VO2AT)and the maximal oxygen uptake(VO2max)increased in 2 groups after the intervention,which was more significant in test group(P<0.05).The level of the maximum heart rate(HRmax)decreased in 2 groups after the intervention,which was more significant in test group(P<0.05).The management levels of symptoms,compliance,daily life,emotion,data and self-efficacy increased in 2 groups after the intervention,which was more significant in test group(P<0.05).After the intervention,the levels of optimism,self-reliance and tenacity increased in 2 groups after the intervention,which was more significant in test group(P<0.05).The level of exercise tolerance had no statistical difference in 2 groups before the intervention(P>0.05).The levels of 6-minute walk distance(6MWD)and exercise tolerance increased in 2 groups after the intervention,which was more significant in test group(P<0.05).Conclusion The phased rehabilitation training has a better effect and can improve cardiopulmonary function and self-efficacy in elderly CHD patients.