冠心病患者出院后一年運(yùn)動(dòng)康復(fù)現(xiàn)狀調(diào)查
發(fā)布時(shí)間：2018-07-21 10:08
【摘要】：目的:通過調(diào)查分析保定市三甲醫(yī)院出院后一年的冠心病人群運(yùn)動(dòng)康復(fù)的現(xiàn)狀,為今后開展心臟康復(fù),特別是社區(qū)、家庭環(huán)境中有效開展心臟運(yùn)動(dòng)康復(fù)提供依據(jù)。方法:本研究以2015年《冠心病患者運(yùn)動(dòng)治療中國(guó)專家共識(shí)》為依據(jù)制定《冠心病患者運(yùn)動(dòng)狀況調(diào)查問卷》,采用定點(diǎn)連續(xù)抽樣的方法,選取曾于2015年3月--8月期間在保定市三所三級(jí)甲等醫(yī)院接受治療的494名冠心病患者,對(duì)其進(jìn)行出院一年后運(yùn)動(dòng)康復(fù)狀況的橫斷面調(diào)查。從中選取知情同意且主觀自我評(píng)價(jià)運(yùn)動(dòng)強(qiáng)度為“中等運(yùn)動(dòng)強(qiáng)度”的患者,利用心肺運(yùn)動(dòng)測(cè)試系統(tǒng)在其日常運(yùn)動(dòng)中對(duì)其進(jìn)行客觀運(yùn)動(dòng)強(qiáng)度檢測(cè),以進(jìn)一步了解冠心病患者的實(shí)際運(yùn)動(dòng)現(xiàn)狀。采用SPSS20.0統(tǒng)計(jì)軟件完成數(shù)據(jù)錄入與統(tǒng)計(jì)分析,對(duì)運(yùn)動(dòng)狀況及相關(guān)內(nèi)容知曉狀況的分布情況主要采用描述性統(tǒng)計(jì)分析,對(duì)可能影響患者運(yùn)動(dòng)參與狀況的一般資料采用卡方檢驗(yàn)。結(jié)果:1.問卷調(diào)查中,出院一年后冠心病患者運(yùn)動(dòng)鍛煉參與率為71.7%。參與運(yùn)動(dòng)鍛煉的人群中:98.5%的患者僅進(jìn)行有氧運(yùn)動(dòng)而未合并抗阻運(yùn)動(dòng);74.8%的患者主觀自我評(píng)價(jià)日常運(yùn)動(dòng)為低強(qiáng)度運(yùn)動(dòng),25.2%的患者主觀自我評(píng)價(jià)日常運(yùn)動(dòng)為中等強(qiáng)度運(yùn)動(dòng);運(yùn)動(dòng)頻率達(dá)到3-5次/周的人群比例為41.6%;運(yùn)動(dòng)持續(xù)時(shí)間達(dá)到20-60分鐘/次的人群比例為57.7%;20.6%的患者在運(yùn)動(dòng)開始和結(jié)束時(shí)會(huì)進(jìn)行熱身和放松運(yùn)動(dòng);能夠正確了解硝酸甘油使用方法的患者為58.5%;運(yùn)動(dòng)中急救藥品攜帶率為23%;所有患者在進(jìn)行運(yùn)動(dòng)康復(fù)前均未接受過專業(yè)的運(yùn)動(dòng)風(fēng)險(xiǎn)評(píng)估與運(yùn)動(dòng)能力評(píng)價(jià)以及專業(yè)的運(yùn)動(dòng)指導(dǎo)。2.共40位主觀自我評(píng)價(jià)日常運(yùn)動(dòng)強(qiáng)度為“中等強(qiáng)度”的患者接受了客觀運(yùn)動(dòng)強(qiáng)度檢測(cè)。其中有2人(5%)和4人(10%)的客觀運(yùn)動(dòng)強(qiáng)度高于、低于“客觀中等運(yùn)動(dòng)強(qiáng)度”上限和下限(60%HRR/40%HRR)。在客觀運(yùn)動(dòng)強(qiáng)度維持在個(gè)體中等強(qiáng)度范圍的條件下,患者平均相對(duì)運(yùn)動(dòng)強(qiáng)度為48.1±4.5HRR%。在客觀運(yùn)動(dòng)強(qiáng)度達(dá)到個(gè)體中等強(qiáng)度的條件下,患者的平均絕對(duì)運(yùn)動(dòng)強(qiáng)度4.6±0.6Mets。達(dá)到個(gè)體無氧閾強(qiáng)度的人數(shù)比例為19%。結(jié)論:所調(diào)查的冠心病人群中,出院一年后運(yùn)動(dòng)鍛煉行為與2015年《冠心病運(yùn)動(dòng)治療中國(guó)專家共識(shí)》中提出的運(yùn)動(dòng)處方相關(guān)內(nèi)容相比,在運(yùn)動(dòng)形式、運(yùn)動(dòng)強(qiáng)度、運(yùn)動(dòng)持續(xù)時(shí)間、運(yùn)動(dòng)頻率、運(yùn)動(dòng)中急救藥品攜帶、硝酸甘油的正確使用以及接受運(yùn)動(dòng)指導(dǎo)等內(nèi)容上與《共識(shí)》的推薦標(biāo)準(zhǔn)存在差距。僅重視有氧運(yùn)動(dòng)而忽略抗阻運(yùn)動(dòng)以及有氧運(yùn)動(dòng)的客觀強(qiáng)度較低是當(dāng)前冠心病患者運(yùn)動(dòng)康復(fù)中最為突出的兩大問題,這可能會(huì)明顯削弱冠心病患者的運(yùn)動(dòng)獲益,可能是導(dǎo)致冠心病患者遠(yuǎn)期預(yù)后不良的重要因素之一。運(yùn)動(dòng)作為心臟康復(fù)的基礎(chǔ)手段,需要臨床和社區(qū)專業(yè)人員給予專門的指導(dǎo),即為患者提供專門的運(yùn)動(dòng)處方,強(qiáng)調(diào)運(yùn)動(dòng)方式、運(yùn)動(dòng)強(qiáng)度、運(yùn)動(dòng)持續(xù)時(shí)間、運(yùn)動(dòng)頻率和注意事項(xiàng),使冠心病患者的運(yùn)動(dòng)康復(fù)科學(xué)、規(guī)范的進(jìn)行。特別需要關(guān)注抗阻運(yùn)動(dòng)的開展,并保證有氧運(yùn)動(dòng)的運(yùn)動(dòng)強(qiáng)度達(dá)標(biāo),從而使冠心病患者從運(yùn)動(dòng)中獲益。
[Abstract]:Objective: through the investigation and analysis of the current situation of the movement rehabilitation of the coronary heart disease population in the first year after discharge in Baoding three a hospital, to provide the basis for the heart rehabilitation, especially in the community and in the family environment. Methods: This study was based on the Chinese expert consensus of "coronary heart disease" in 2015. The exercise status questionnaire was used to select 494 coronary heart disease patients who had been treated in three grade three grade A hospitals in Baoding city during --8 month of March 2015. A cross-sectional survey of exercise rehabilitation after one year of discharge was carried out. In order to further understand the actual movement of the patients with coronary heart disease, the cardiopulmonary exercise test system was used to detect the actual movement of coronary heart disease. The SPSS20.0 statistical software was used to complete the data entry and statistical analysis, and the distribution of the state of awareness of the movement and related contents was carried out by the cardiopulmonary exercise test system. Descriptive statistical analysis was used to analyze the general data that may affect the participation of patients. Results: in the 1. questionnaire survey, one year after discharge, the participation rate of coronary heart disease patients was 71.7%. involved in exercise: 98.5% of the patients only performed aerobic exercise without anti resistance exercise; 74.8% of the patients were not involved in the exercise. The subjective self-evaluation of daily exercise was low intensity exercise, and 25.2% of the patients had subjective self evaluation of moderate intensity exercise; the rate of 3-5 times per week was 41.6%, and the proportion of people with a duration of 20-60 minutes / times was 57.7%; 20.6% of the patients were warmer and relaxed at the beginning and end of the exercise. The patients who were able to understand the use of nitroglycerin correctly were 58.5%, and the first aid drug carrying rate in exercise was 23%. All patients had not received professional exercise risk assessment, exercise ability evaluation and professional exercise guidance.2. before exercise rehabilitation, and 40 subjective self I evaluated daily exercise intensity as "medium intensity". The patients received objective exercise intensity test. The objective exercise intensity of 2 (5%) and 4 (10%) was higher than that of "objective moderate exercise intensity" upper limit and lower limit (60%HRR/40%HRR). The average relative motion intensity of the patient was 48.1 + 4.5HRR%. at the objective movement intensity under the condition that the objective exercise intensity was maintained at the medium intensity range. The ratio of the average absolute exercise intensity of 4.6 + 0.6Mets. to the individual anaerobic threshold was 19%.. The exercise behavior in the coronary heart disease population was compared with the exercise prescription related to the Chinese expert consensus of the 2015 coronary heart disease exercise therapy. In the form of exercise, the intensity of exercise, the duration of exercise, the frequency of exercise, the carrying of first-aid drugs in the exercise, the correct use of nitroglycerin, and the acceptance of exercise guidance, there is a gap between the recommendations of the "consensus >". The two most prominent problems in dynamic rehabilitation may obviously weaken the exercise benefit of patients with coronary heart disease, which may be one of the important factors that lead to poor prognosis in patients with coronary heart disease. As a basic means of heart rehabilitation, exercise should be given by clinical and community professionals to provide special exercise prescriptions for patients. It emphasizes sports, exercise intensity, duration of exercise, movement frequency and attention, which makes the exercise rehabilitation of coronary heart disease patients scientific and standardized. We should pay special attention to the development of resistance movement and ensure that the intensity of aerobic exercise is up to the standard, so that the patients of coronary heart disease can benefit from the exercise.
【學(xué)位授予單位】：河北大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R473.5
本文編號(hào)：2135178
[Abstract]:Objective: through the investigation and analysis of the current situation of the movement rehabilitation of the coronary heart disease population in the first year after discharge in Baoding three a hospital, to provide the basis for the heart rehabilitation, especially in the community and in the family environment. Methods: This study was based on the Chinese expert consensus of "coronary heart disease" in 2015. The exercise status questionnaire was used to select 494 coronary heart disease patients who had been treated in three grade three grade A hospitals in Baoding city during --8 month of March 2015. A cross-sectional survey of exercise rehabilitation after one year of discharge was carried out. In order to further understand the actual movement of the patients with coronary heart disease, the cardiopulmonary exercise test system was used to detect the actual movement of coronary heart disease. The SPSS20.0 statistical software was used to complete the data entry and statistical analysis, and the distribution of the state of awareness of the movement and related contents was carried out by the cardiopulmonary exercise test system. Descriptive statistical analysis was used to analyze the general data that may affect the participation of patients. Results: in the 1. questionnaire survey, one year after discharge, the participation rate of coronary heart disease patients was 71.7%. involved in exercise: 98.5% of the patients only performed aerobic exercise without anti resistance exercise; 74.8% of the patients were not involved in the exercise. The subjective self-evaluation of daily exercise was low intensity exercise, and 25.2% of the patients had subjective self evaluation of moderate intensity exercise; the rate of 3-5 times per week was 41.6%, and the proportion of people with a duration of 20-60 minutes / times was 57.7%; 20.6% of the patients were warmer and relaxed at the beginning and end of the exercise. The patients who were able to understand the use of nitroglycerin correctly were 58.5%, and the first aid drug carrying rate in exercise was 23%. All patients had not received professional exercise risk assessment, exercise ability evaluation and professional exercise guidance.2. before exercise rehabilitation, and 40 subjective self I evaluated daily exercise intensity as "medium intensity". The patients received objective exercise intensity test. The objective exercise intensity of 2 (5%) and 4 (10%) was higher than that of "objective moderate exercise intensity" upper limit and lower limit (60%HRR/40%HRR). The average relative motion intensity of the patient was 48.1 + 4.5HRR%. at the objective movement intensity under the condition that the objective exercise intensity was maintained at the medium intensity range. The ratio of the average absolute exercise intensity of 4.6 + 0.6Mets. to the individual anaerobic threshold was 19%.. The exercise behavior in the coronary heart disease population was compared with the exercise prescription related to the Chinese expert consensus of the 2015 coronary heart disease exercise therapy. In the form of exercise, the intensity of exercise, the duration of exercise, the frequency of exercise, the carrying of first-aid drugs in the exercise, the correct use of nitroglycerin, and the acceptance of exercise guidance, there is a gap between the recommendations of the "consensus >". The two most prominent problems in dynamic rehabilitation may obviously weaken the exercise benefit of patients with coronary heart disease, which may be one of the important factors that lead to poor prognosis in patients with coronary heart disease. As a basic means of heart rehabilitation, exercise should be given by clinical and community professionals to provide special exercise prescriptions for patients. It emphasizes sports, exercise intensity, duration of exercise, movement frequency and attention, which makes the exercise rehabilitation of coronary heart disease patients scientific and standardized. We should pay special attention to the development of resistance movement and ensure that the intensity of aerobic exercise is up to the standard, so that the patients of coronary heart disease can benefit from the exercise.
【學(xué)位授予單位】：河北大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R473.5
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