摘要
目的:通过考察左心室射血分数、情绪评估分数及左右手肌力评估结果,对比加强Ⅰ期心脏康复训练和普通Ⅰ期心脏康复指导干预1周对冠状动脉旁路移植术(CABG)后患者的短期疗效。方法:选取阜外医院心脏外科病房2015-07至2015-10行CABG的患者254例,男性196例,女性58例,平均年龄(59.92±7.80)岁。工作小组术前即介入进行包含心脏康复内容的术前宣教,对所有患者进行超声心动图、情绪及左右手肌力的评估,术后第1天立即按照患者个人意愿进入试验组(n=160)及对照组(n=94),试验组由康复师每天一对一进行心脏康复指导,对照组心脏康复指导则由康复师在术前统一进行,一周后工作小组对两组患者的相应指标再次进行评估。主要关注左心室射血分数值;情绪评估采用9项病例健康问卷(PHQ-9)和7项广泛性焦虑(GAD-7)自评量表。结果:两组患者在左心室射血分数、PHQ-9抑郁评分、GAD-7焦虑评分、左右手握力等方面,差异无统计学意义。试验组患者术后左心室射血分数值[(62.88±5.21)%]较对照组[(59.00±9.83)%]略高,差异有统计学意义(P<0.05);试验组患者PHQ-9抑郁评分及GAD-7焦虑评分较对照组略低,左右手握力均较对照组略高,但差异均无统计学意义。结论:本试验中,试验组患者虽然表现出了较为微弱的优势,但其大部分优势并无统计学意义,如患者术后情绪评估及左右手握力等,但试验组患者术后左心室射血分数略高于对照组患者,差异有统计学意义,说明即使是持续仅为一周的Ⅰ期心脏康复,患者还是可以获得较有意义的益处。
Objective： To compare short-term efficacy of enhanced phase-I cardiac rehabilitation and ordinary phase-Ⅰ cardiac rehabilitation in patients after coronary artery bypass grafting （CABG）. Methods： A total of 254 patients received CABG in our hospital from 2015-07 to 2015-10 were enrolled including 196 male and 58 female at the mean age of （59.92±7.80） years. Relevant health education was conducted and echocardiography, emotion, grip strength were assessed before operation. Based on personal aspiration, the patients were assigned to 2 groups at the 1st day after CABG： Enhanced phase-I cardiac rehabilitation （Enhanced） group, the patients received every day one to one training by physical therapist for 7 days and Ordinary phase-I cardiac rehabilitation （Ordinary） group, the patients received unified instruction by physical therapist prior operation. Relevant parameters were compared between 2 groups at 1 week post-operation which were mainly focused on left ventricular ejection fraction （LVEF）, emotional assessment as health questionnaire 9-items （PHQ-9）, generalized anxiety disorder 7-items （GAD-7） and grip strength. Results： Before operation： LVEF, PHQ-9 scores, GAD-7 scores and grip strength were similar between 2 groups.1 week post-operation： compared with Ordinary group, Enhanced group had the higher LVEF （62.88±5.21） % vs （59.00±9.83） %, P〈0.05; Enhanced group showed slightly lower PHQ-9, GAD-7 scores and slightly higher grip strength without statistic meaning. Conclusion： Enhanced phase-I cardiac rehabilitation presented slight superiority as improved LVEF which implied that even 1 week specific training may benefit CABG patients.
出处
《中国循环杂志》
CSCD
北大核心
2017年第4期318-321,共4页
Chinese Circulation Journal
关键词
康复
冠状动脉旁路移植术
健康状况指标
Rehabilitation
Coronary artery bypass grafting
Health status indicatiors
