摘要
目的:观察心理干预联合运动训练对冠状动脉搭桥(CABG)患者术后恢复及心功能的影响。方法:52例拟行CABG的住院患者随机分为康复组(n=27)和对照组(n=25)。康复组给予心理干预治疗和强度渐增的运动。主要观察指标为:焦虑自评量表(SAS)、抑郁自评量表(SDS)、6min步行试验(6MWT)、肿瘤坏死因子α(TNFα)、左室射血分数(LVEF)、术后插管时间、重症护理时间与术后住院时间。结果:与对照组比较,康复组患者术后SAS与SDS评分下降显著(P<0.01);康复组患者6min步行距离(6MWD)明显加长(P<0.005);康复组TNF-α浓度明显降低(P<0.01);康复组患者术后呼吸机辅助通气时间及重症监护时间较对照组缩短(P<0.05);与术前比较,康复组LVEF明显改善(P<0.005);将康复组患者的上述观察指标进行相关性分析,结果显示SAS、SDS评分的下降分别与6MWD的加长(rSAS=0.46,P<0.01;rSDS=0.48,P<0.01)成明显正相关。结论:心理干预联合运动训练可以改善CABG术后患者的焦虑及抑郁程度,提高运动能力,促进心脏功能的恢复。
Objective：To observe the effects of psychological intervention combined with exercise training on postoperation recovery and heart function in patients after coronary artery bypass graft（CABG）.Method：Fifty-two in patients who had to take CABG were randomly assigned to cardiac rehabilitation group（rehab,n=27） or to usual care group（control,n=25）.In rehab group,progressive strengthening movement and psychological intervention were applied.The main observation indicators were：self-rating anxiety scale（SAS）,self-rating depression scale（SDS）,6 min walking test（6MWT）,tumor necrosis factor-α（TNF-α）,left ventricular ejection fraction（LVEF）,duration of post-operation ventilation with breathing machine,duration of post-operation intensive care and duration of post-operation stay.Result：Compared with control group,in rehab group the postoperation scores of SAS and SDS dropped significantly（P〈0.01）.In rehab group 6-min walking distance（6MWD） was significantly langer than that in control group（P〈0.005）.TNF-α level in rehab group decreased（P〈0.01）.The duration of post-operation ventilation with breathing machine and intensive care also reduced in rehab group（P〈0.05）.Rehab patient’s postoperation LVEF improved compared with preoperation（P〈0.05）.Furthermore,the rehab group showed a positive correlation between SAS（r=0.46,P〈0.01）,SDS（r=0.48,P〈0.01） and 6MWD respectively.Conclusion：Psychological intervention combined with exercise training in patients after GABG may drop the levels of anxiety and depression,improve exercise capacity and improve heart function
出处
《中国康复医学杂志》
CAS
CSCD
北大核心
2011年第10期929-934,共6页
Chinese Journal of Rehabilitation Medicine
基金
辽宁省教育厅高等学校科学技术研究项目(20060977)
关键词
冠脉搭桥术
康复
焦虑
抑郁
6分钟步行试验
coronary artery bypass graft
rehabilitation
anxiety
depression
six minutes walking test
