冠心病PCI术后患者参与式运动康复方案的构建与应用

Construction and application of participatory exercise rehabilitation program for patients with coronary heart disease after PCI

目的构建基于患者健康参与模型(PHE模型)的运动康复方案,并探讨其对冠心病经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后患者的干预效果。方法基于PHE模型,在文献回顾以及专家函询的基础上,构建冠心病PCI术后运动康复方案。选取2022年8月至2023年8月在华北理工大学附属医院心内科住院的84例稳定型冠心病患者为研究对象,采用随机数字表将患者分为两组,每组各42例,对照组实施常规护理,试验组在常规护理基础上实施基于PHE模型的运动康复干预方案。收集患者入院至出院后1个月、2个月、3个月内的相关数据,比较两组运动依从性、无氧阈、峰值摄氧量、6 min步行试验距离以及因不良心血管事件再入院率的差异。结果干预1个月、2个月、3个月后,试验组运动依从性显著优于对照组,干预3个月后,试验组患者无氧阈、峰值摄氧量、6 min步行试验距离(15.41±2.01)mL/(min·kg)、(19.14±1.95)mL/(min·kg)、(451.21±29.01)m分别高于对照组(13.40±2.52)mL/(min·kg)、(16.64±2.39)mL/(min·kg)、(426.79±30.15)m,差异有统计学意义(P<0.05);两组患者干预后因不良心血管事件再入院率比较,差异无统计学意义(P>0.05)。结论基于PHE模型的运动康复方案,有效提高了冠心病PCI术后患者的运动依从性以及运动耐力。

Objective To construct an exercise rehabilitation program based on patient health engagement(PHE)model and explore the effect of exercise rehabilitation on patients with coronary heart disease after PCI.Methods Based on the PHE model,the exercise rehabilitation program of coronary heart disease after PCI was established on the basis of literature review and expert correspondence.A total of 84 patients with stable coronary heart disease who were hospitalized in the Department of Cardiology,Affiliated Hospital of North China University of Science and Technology from August 2022 to August 2023 were selected as the study objects.The patients were divided into two groups by random number table,with 42 cases in each group.The control group received routine nursing,and the experimental group received exercise rehabilitation intervention program based on PHE model on the basis of routine nursing.Related data were collected from hospital admission to 1 month,2 months,and 3 months after discharge,and the differences in exercise compliance,anaerobic threshold,VO2peak,6-minute walking test distance,and readmission rate due to adverse cardiovascular events were compared between the two groups.Results After 1 month,2 months and 3 months of intervention,the exercise compliance of the experimental group was significantly better than that of the control group.Anaerobic threshold,VO2peak,6-minute walking test distance of(15.41±2.01)mL/(min·kg),(19.14±1.95)mL/(min·kg)and(451.21±29.01)m were higher than those of the control group of(13.40±2.52)mL/(min·kg),(16.64±2.39)mL/(min·kg),and(426.79±30.15)m respectively,and the difference was statistically significant(P<0.05);There was no significant difference in readmission rate due to adverse cardiovascular events between the two groups after intervention(P>0.05).Conclusion Exercise rehabilitation program based on the PHE model can effectively improve exercise compliance and exercise endurance of patients with coronary heart disease after PCI.