本文選題：心臟起搏器 + 人工��； 參考：《中國全科醫(yī)學(xué)》2017年20期

【摘要】：目的探討早期康復(fù)對心臟起搏器植入術(shù)后患者生活質(zhì)量、肩關(guān)節(jié)并發(fā)癥及電極脫位事件發(fā)生的影響。方法選取2013—2015年紹興市人民醫(yī)院心內(nèi)科行心臟永久起搏器植入術(shù)患者220例為研究對象。根據(jù)住院時(shí)間順序編號,偶數(shù)為早期康復(fù)組(110例),奇數(shù)為傳統(tǒng)治療組(110例)。傳統(tǒng)治療組患者接受常規(guī)康復(fù)措施,早期康復(fù)組患者從術(shù)后6h開始由專人按照不同的程序、循序漸進(jìn)的功能鍛煉進(jìn)行術(shù)后康復(fù)干預(yù),術(shù)后12 h可下床活動。于術(shù)后兩周、3個(gè)月時(shí),采用SF-36評價(jià)患者生活質(zhì)量,肩關(guān)節(jié)疼痛和功能障礙指數(shù)(SPADI)評價(jià)患者可能存在的肩關(guān)節(jié)疼痛、活動障礙情況,通過X線片評估電極脫位事件。結(jié)果早期康復(fù)組術(shù)后兩周SF-36生理功能、生理職能、軀體疼痛、總體健康、活力、社會功能、情感職能、心理健康、軀體健康總評及心理健康總評得分均高于傳統(tǒng)治療組(P0.05)。早期康復(fù)組術(shù)后3個(gè)月生理功能、生理職能、軀體疼痛、總體健康、社會功能、情感職能、心理健康、軀體健康總評及心理健康總評得分均高于傳統(tǒng)治療組(P0.05)。兩組術(shù)后兩周SPADI比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05);早期康復(fù)組術(shù)后3個(gè)月SPADI低于傳統(tǒng)治療組(P0.05)。兩組術(shù)后兩周及術(shù)后3個(gè)月電極脫位事件發(fā)生率比較,差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論與傳統(tǒng)治療相比,起搏器植入術(shù)后6h開始進(jìn)行早期康復(fù)干預(yù)更有利于提高患者生活質(zhì)量,降低肩關(guān)節(jié)疼痛和活動障礙,且并不增加電極脫位事件的發(fā)生。
[Abstract]:Objective to investigate the effects of early rehabilitation on quality of life, shoulder complications and electrode dislocation in patients with cardiac pacemaker implantation. Methods 220 patients undergoing cardiac pacemaker implantation in Department of Cardiology, Shaoxing people's Hospital from 2013 to 2015 were selected as subjects. According to the number of hospital stay, even number was early rehabilitation group (110 cases), odd number was traditional treatment group (110 cases). The patients in the traditional treatment group received routine rehabilitation measures, and the patients in the early rehabilitation group received rehabilitation intervention in accordance with different procedures and progressive functional exercises from 6 hours after operation. The patients in the early rehabilitation group could get out of bed at 12 hours after operation. At two weeks and three months after operation, the quality of life (QOL), shoulder pain and dysfunction index (SPADI) were evaluated by SF-36. Results the scores of SF-36 physiological function, somatic pain, general health, vitality, social function, emotional function, mental health, physical health and mental health in early rehabilitation group were higher than those in traditional treatment group two weeks after operation (P0.05). The scores of physiological function, somatic pain, general health, social function, emotional function, mental health, general evaluation of physical health and general evaluation of mental health in early rehabilitation group were higher than those in traditional treatment group 3 months after operation (P0.05). There was no significant difference in SPADI between the two groups two weeks after operation (P0.05), and SPADI in early rehabilitation group was lower than that in traditional treatment group 3 months after operation (P0.05). There was no significant difference in the incidence of electrode dislocation events between the two groups two weeks after operation and three months after operation (P0.05). Conclusion compared with the traditional treatment, the early rehabilitation intervention 6 hours after pacemaker implantation is more helpful to improve the quality of life, reduce shoulder pain and movement disorder, and do not increase the occurrence of electrode dislocation.
【作者單位】： 浙江省紹興市人民醫(yī)院浙江大學(xué)紹興醫(yī)院心內(nèi)科;
【基金】：浙江省紹興市科技項(xiàng)目(2014B70059)
【分類號】：R54

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