【摘要】：目的:通過考察左心室射血分?jǐn)?shù)、情緒評(píng)估分?jǐn)?shù)及左右手肌力評(píng)估結(jié)果,對(duì)比加強(qiáng)Ⅰ期心臟康復(fù)訓(xùn)練和普通Ⅰ期心臟康復(fù)指導(dǎo)干預(yù)1周對(duì)冠狀動(dòng)脈旁路移植術(shù)(CABG)后患者的短期療效。方法:選取阜外醫(yī)院心臟外科病房2015-07至2015-10行CABG的患者254例,男性196例,女性58例,平均年齡(59.92±7.80)歲。工作小組術(shù)前即介入進(jìn)行包含心臟康復(fù)內(nèi)容的術(shù)前宣教,對(duì)所有患者進(jìn)行超聲心動(dòng)圖、情緒及左右手肌力的評(píng)估,術(shù)后第1天立即按照患者個(gè)人意愿進(jìn)入試驗(yàn)組(n=160)及對(duì)照組(n=94),試驗(yàn)組由康復(fù)師每天一對(duì)一進(jìn)行心臟康復(fù)指導(dǎo),對(duì)照組心臟康復(fù)指導(dǎo)則由康復(fù)師在術(shù)前統(tǒng)一進(jìn)行,一周后工作小組對(duì)兩組患者的相應(yīng)指標(biāo)再次進(jìn)行評(píng)估。主要關(guān)注左心室射血分?jǐn)?shù)值;情緒評(píng)估采用9項(xiàng)病例健康問卷(PHQ-9)和7項(xiàng)廣泛性焦慮(GAD-7)自評(píng)量表。結(jié)果:兩組患者在左心室射血分?jǐn)?shù)、PHQ-9抑郁評(píng)分、GAD-7焦慮評(píng)分、左右手握力等方面,差異無統(tǒng)計(jì)學(xué)意義。試驗(yàn)組患者術(shù)后左心室射血分?jǐn)?shù)值[(62.88±5.21)%]較對(duì)照組[(59.00±9.83)%]略高,差異有統(tǒng)計(jì)學(xué)意義(P0.05);試驗(yàn)組患者PHQ-9抑郁評(píng)分及GAD-7焦慮評(píng)分較對(duì)照組略低,左右手握力均較對(duì)照組略高,但差異均無統(tǒng)計(jì)學(xué)意義。結(jié)論:本試驗(yàn)中,試驗(yàn)組患者雖然表現(xiàn)出了較為微弱的優(yōu)勢,但其大部分優(yōu)勢并無統(tǒng)計(jì)學(xué)意義,如患者術(shù)后情緒評(píng)估及左右手握力等,但試驗(yàn)組患者術(shù)后左心室射血分?jǐn)?shù)略高于對(duì)照組患者,差異有統(tǒng)計(jì)學(xué)意義,說明即使是持續(xù)僅為一周的Ⅰ期心臟康復(fù),患者還是可以獲得較有意義的益處。
[Abstract]:Objective: to investigate the results of left ventricular ejection fraction (LVEF), emotional assessment score (ESR) and left and right hand muscle strength (LVEF). To compare the short-term effect of intensive stage I cardiac rehabilitation training and general stage I cardiac rehabilitation intervention on patients with coronary artery bypass grafting (CABG) for one week. Methods: 254 patients with CABG from 2015-07 to 2015-10 in Cardiac surgery ward of Fuwei Hospital were selected, including 196 males and 58 females, with an average age of (59.92 鹵7.80) years. The working group interventional preoperatively, including cardiac rehabilitation, to assess the echocardiography, mood, and strength of the left and right hand in all patients. On the first day after operation, the patients were admitted to the experimental group (NN160) and the control group (nny94) according to the patient's personal wishes. The experimental group was given one to one cardiac rehabilitation instruction by the rehabilitator every day, while the control group was uniformly conducted by the rehabilitator before the operation. A week later, the working group re-evaluated the corresponding indicators for both groups of patients. The left ventricular ejection fraction (LVEF) was mainly studied, and 9 cases health questionnaire (PHQ-9) and 7 generalized anxiety scale (GAD-7) were used for emotional assessment. Results: there was no significant difference in left ventricular ejection fraction, PHQ-9 depression score, GAD-7 anxiety score, left and right hand grip strength between the two groups. The left ventricular ejection score in the experimental group [(62.88 鹵5.21)%] was slightly higher than that in the control group [(59.00 鹵9.83)%], the difference was statistically significant (P0.05). The scores of PHQ-9 depression and GAD-7 anxiety in the trial group were slightly lower than those in the control group, and the grip strength of the left and right hand was slightly higher than that of the control group, but the difference was not statistically significant. Conclusion: in this study, although the patients in the trial group showed weak advantages, most of the advantages were not statistically significant, such as postoperative emotional evaluation and grip strength of the left and right hand, etc. But the left ventricular ejection fraction in the trial group was slightly higher than that in the control group. The difference was statistically significant.
【作者單位】： 中國醫(yī)學(xué)科學(xué)院北京協(xié)和醫(yī)學(xué)院國家心血管病中心阜外醫(yī)院心臟康復(fù)中心;中國中醫(yī)科學(xué)院西苑醫(yī)院心血管病中心;
【分類號(hào)】：R654.2

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