本文選題：慢性心力衰竭 + 心臟再同步化治療�。� 參考：《浙江大學(xué)》2016年碩士論文

【摘要】：目的我國(guó)心臟病防治仍停留在發(fā)達(dá)國(guó)家20世紀(jì)60年代水平,隨著心臟病發(fā)病率的逐年上升,近10年來(lái)國(guó)內(nèi)心臟康復(fù)也逐漸發(fā)展和完善,但最要還是集中在冠心病等慢性心血管內(nèi)科疾病的康復(fù),隨著心血管介入醫(yī)學(xué)的發(fā)展,心臟康復(fù)治療也從傳統(tǒng)的心血管內(nèi)科的康復(fù)發(fā)展到心血管介人性治療后康復(fù),在國(guó)外有研究實(shí)踐證明,康復(fù)運(yùn)動(dòng)治療對(duì)于心血管介入術(shù)后,從生理、心理、社會(huì)等多種角度提高患者的生活質(zhì)量,有極其重要的意義；在國(guó)內(nèi)目前還沒(méi)有關(guān)于心臟再同步化治療(cardiac resynchronization therapy,CRT)術(shù)后康復(fù)的相關(guān)研究報(bào)道。因此,我們對(duì)探討系統(tǒng)康復(fù)宣教、專業(yè)康復(fù)指導(dǎo)對(duì)CRT患者體能、生存質(zhì)量和心理狀態(tài)的影響做了相關(guān)研究。方法選取CRT患者58例,隨機(jī)分為康復(fù)組(n=28)和對(duì)照組(n=30),康復(fù)組患者在相關(guān)臨床治療、護(hù)理宣教的基礎(chǔ)上由康復(fù)醫(yī)師進(jìn)行系統(tǒng)宣教,在建立健康生活方式,改變不良生活習(xí)慣及體能、功能鍛煉專業(yè)指導(dǎo)；對(duì)照組只進(jìn)行常規(guī)臨床相關(guān)治療和護(hù)理宣教。比較兩組患者CRT術(shù)后出院時(shí),術(shù)后1個(gè)月、術(shù)后3個(gè)月和術(shù)后6個(gè)月門(mén)診定期復(fù)診和電話隨訪,在生活方式的轉(zhuǎn)變,體能(6分鐘步行測(cè)試、Borg指數(shù))和生存質(zhì)量、心理狀態(tài)(SF-36健康調(diào)查量表中文版)的差異,以分析不同干預(yù)措施對(duì)患者的影響。結(jié)果CRT術(shù)后出院時(shí),術(shù)后1個(gè)月、術(shù)后3個(gè)月和術(shù)后6個(gè)月的門(mén)診定期復(fù)診和電話隨訪評(píng)估中,康復(fù)組患者建立良好生活方式達(dá)標(biāo)率更高,體能改善更為明顯(6分鐘步行試驗(yàn)、Borg指數(shù))(P0.01),SF-36健康調(diào)查量表中文版中的軀體功能、一般健康狀況、精力、情感職能和心理健康評(píng)分均顯著改善,差異具有統(tǒng)計(jì)學(xué)意義(P0.01)。三者相輔相成,患者生活質(zhì)量明顯提高。結(jié)論①系統(tǒng)、專業(yè)的康復(fù)健康宣教學(xué)習(xí)對(duì)心臟在同步化治療術(shù)后患者的干預(yù)后,提高慢性心力衰竭患者自我對(duì)疾病認(rèn)識(shí)和保健意識(shí),對(duì)危險(xiǎn)因素的控制更加嚴(yán)格,積極建立健康的生活方式,養(yǎng)成良好的生活習(xí)慣和心理思維方式,提高CRT術(shù)后療效；②康復(fù)運(yùn)動(dòng)指導(dǎo),改變患者術(shù)后臥床休息的老觀念,增強(qiáng)患者的活動(dòng)意識(shí),讓患者早期參加活動(dòng),體能恢復(fù)更快,促進(jìn)術(shù)后恢復(fù),提高生活質(zhì)量。③系統(tǒng)、專業(yè)的康復(fù)健康宣教學(xué)習(xí)對(duì)心臟在同步化治療術(shù)后患者的干預(yù)后,患者的心理狀況發(fā)生了變化,主要集中在生理機(jī)能、生理職能、軀體疼痛、一般健康狀況、精力、社會(huì)功能、情感職能以及精神健康等8個(gè)方面發(fā)生了變化,生活質(zhì)量明顯提高。
[Abstract]:Objective the prevention and treatment of heart disease in China is still at the level of the developed countries in the 1960s. With the increase of the incidence of heart disease year by year, the heart rehabilitation in China has gradually developed and improved in the past 10 years. However, it is most important to focus on the rehabilitation of chronic cardiovascular diseases such as coronary heart disease. With the development of cardiovascular interventional medicine, cardiac rehabilitation treatment has also developed from the rehabilitation of traditional cardiovascular medicine to the rehabilitation of cardiovascular mediating humanity. Research practice in foreign countries has proved that rehabilitation exercise therapy is of great significance to improve the quality of life of patients from the aspects of physiology, psychology, society and so on. There are no reports on cardiac resynchronization after (cardiac resynchronization therapy in China. Therefore, we studied the effects of systematic rehabilitation education and professional rehabilitation guidance on the physical ability, quality of life and mental state of CRT patients. Methods Fifty-eight patients with CRT were randomly divided into two groups: rehabilitation group (n = 28) and control group (n = 30). Patients in rehabilitation group were given systematic education by rehabilitation doctors on the basis of related clinical treatment and nursing education, and healthy lifestyle was established. The patients in the control group were given routine clinical treatment and nursing education. To compare the two groups of CRT patients were discharged from hospital, 1 month, 3 months and 6 months after operation, regular follow-up and telephone follow-up, changes in lifestyle, physical fitness (6-minute walking test of Borg index) and quality of life (QOL) were compared between the two groups. Mental state (Chinese version of SF-36 Health Survey scale) to analyze the influence of different intervention measures on patients. Results at the time of discharge after CRT, the rate of establishing a good lifestyle was higher in the rehabilitation group than in the rehabilitation group during the regular follow-up and telephone follow-up at 1 month, 3 months and 6 months after CRT. The improvement of physical fitness (6-minute walking test Borg index) (P0.01) and the Chinese version of SF-36 health survey scale showed significant improvement in physical function, general health status, energy, emotional function and mental health score (P0.01), and the difference was statistically significant (P0.01). The three supplement each other, and the quality of life of the patients is obviously improved. Conclusion (1) systematic, professional rehabilitation and health education for patients with chronic heart failure after synchronous treatment can improve their self-awareness of the disease and health care, and control the risk factors more strictly. We should actively establish a healthy lifestyle, develop good habits of life and mental thinking, improve the curative effect of CRT and improve the rehabilitation exercise guidance, change the old concept of bed rest after CRT, and enhance the activity consciousness of the patients. Let the patients take part in the activities early, recover the physical ability faster, promote the postoperative recovery, improve the quality of life system. The psychological status of the patients has changed after the intervention of the professional rehabilitation health education and study to the patients after the synchronous treatment of the heart. It is mainly focused on 8 aspects, such as physiological function, body pain, general health condition, energy, social function, emotional function and mental health, and the quality of life has been improved obviously.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R473.5

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 曾莉;朱曉萍;陳亞梅;吳茜;孫曉;施雁;;我國(guó)“醫(yī)院-社區(qū)-家庭”慢性病連續(xù)性照護(hù)服務(wù)制約因素的研究進(jìn)展[J];護(hù)理研究;2015年11期

2 陳偉偉;高潤(rùn)霖;劉力生;朱曼璐;王文;王擁軍;吳兆蘇;胡盛壽;;中國(guó)心血管病報(bào)告2013概要[J];中國(guó)循環(huán)雜志;2014年07期

3 謝詠梅;;早期康復(fù)護(hù)理對(duì)急性心肌梗死患者的療效[J];心血管康復(fù)醫(yī)學(xué)雜志;2014年03期

4 郭蘭;李梅;;慢性心力衰竭康復(fù)治療的研究進(jìn)展[J];嶺南心血管病雜志;2013年04期

5 丁榮晶;;《冠心病心臟康復(fù)/二級(jí)預(yù)防中國(guó)專家共識(shí)》解讀[J];嶺南心血管病雜志;2013年02期

6 蔡愛(ài)寧;滕志濤;郭志勇;江慧迪;趙惠娟;孫杏云;;氣體代謝運(yùn)動(dòng)試驗(yàn)指導(dǎo)心力衰竭病人康復(fù)治療的效果[J];心血管康復(fù)醫(yī)學(xué)雜志;2012年05期

7 姚成棟;李福;馬毅兵;;太極拳運(yùn)動(dòng)對(duì)慢性心力衰竭患者康復(fù)的作用[J];心血管康復(fù)醫(yī)學(xué)雜志;2010年04期

8 解瑞東;祝亮華;馬衛(wèi)華;;心理干預(yù)對(duì)冠心病患者焦慮抑郁情緒及其生活質(zhì)量的影響[J];中國(guó)醫(yī)療前沿;2009年16期

9 付彩虹;;運(yùn)動(dòng)康復(fù)對(duì)慢性心力衰竭患者的療效評(píng)估[J];中國(guó)廠礦醫(yī)學(xué);2008年02期

10 劉澤銀;李瓊;羅英;鄒旭;吳煥林;嚴(yán)夏;林曉忠;黃桂寶;;心可舒片對(duì)冠心病心絞痛患者生活質(zhì)量的影響[J];廣州醫(yī)藥;2007年04期

，

本文編號(hào)：2077314