运动疗法对冠心病经皮冠状动脉腔内成形术后患者生活质量的影响

Effect of exercise therapy on the quality of life in patients after successful percutaneous tranluminal coronary angioplasty

目的：评价康复运动疗法对冠心病经皮冠状动脉腔内成形术(percutaneous transluminal coronary angioplasty,PTCA)成功后患者生活质量的影响,了解其心理、生理、社会适应能力及冠心病防治知识认知等功能预后因素。 方法:随机选择冠心病PTCA成功术后患者109例,有78例接受康复运动疗法为康复治疗组,有31例为常规治疗组。由研究对象本人完成冠心病生活质量量表。按Ⅱ期运动方案制定康复运动疗法运动处方。运动强度用靶心率表示,取最大心率的70％～85％,结合使用疲劳程度指示。运动方式为步行、慢跑、踏车、摇臂运动,运动持续时间30～60 min。康复运动疗法每周3次,12周为1个疗程。 结果:分发量表125份,全部完成有109份,完成率87％。两组在性别、年龄、教育、婚姻、职业间差异无统计学意义(P>0.05),具有均衡性。结果显示两组生活质量总分值差异有显著性(t=2.63,P=0.01),两组冠心病综合防治知识认知得分值差异有非常显著性(t=4.74,P<0.001),均为康复治疗组QOL分值高于常规治疗组。结合其90％可信区间(90％ confidence interval,90％CI)分析显示2组的90％CI未相互重叠。而2组生理状态部分、心理/精神状态部分、社会适应能力与社会关系支持部分得分值差异无统计学意义(分别为t=0.879,P>0.05;t=1.04,P>0.05;t-1.

AIM: To evaluate the effects of cardiac rehabilitation exercise therapy on the quality of life in patients after successful percutaneous transluminal coronary angioplasty (PTCA), and to study their psychological and physiological status, the social adaptation ability, sub-score of knowledge/practices in coronary heart disease(CHD) prevention/control. METHODS: Totally 109 CAD patients after successful PTCA were randomly selected, 78 of them were set in the rehabilitation exercise group and 31 in the control group (routine treatment). All the patients finished the CAD QOL questionnaire by themselves. The prescription of rehabilitation exercise therapy was set according to exercise scheme phase II. Exercise intensity was denoted with the target heart rate(HR), which was at the 70% - 85% of the HRmax, fatigue level indication was also used. The types of exercise were walking, jogging, treadmill and arm-waggling, and the exercise lasted for about 30 - 60 mins, 3 times a week, 12 weeks a course. RESULTS: Together 125 QOL questionnaires were distributed and 109 were taken back, the finished rate was 87%. There were equitability and no significant differences in sex, age, education, marriage and occupation existed between the two groups ( P > 0. 05). The results showed there was significant difference between the two groups in total score of QOL( t = 2. 63, P = 0. 01), and very significant difference in sub-score of knowledge/practices in CHD prevention/control(t = 4. 74, P < 0. 001), those in the rehabilitation exercise group were higher than those in the control group. Combined with its 90% confidence interval (90% CI), the results showed that no overlapping of 90% CI between the two groups, but no difference was observed in the scores of psychological and physiological status, social adaptation ability and social supports(t= 0.879, P> 0.05; t = 1.04, P> 0.05; t = 1.67, P> 0.05). CONCLUSION: The total QOL score in CAD patients after successful PTCA can be improved by cardiac rehabilitation exercise therapy. The movable a-bility, sex life, returning to work and the CAD second prevention knowledge could be significantly improved by the rehabilitation exercise therapy.