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目的:观察基于运动负荷试验指导下的有氧康复运动在心肌梗死经皮冠状动脉介入治疗(PCI)术后患者中的应用疗效。方法:选取2015年5月至2016年12月广州医科大学附属第三医院收治的心肌梗死患者90例,均行PCI术,术后6周采用随机数字表法将其分为对照组(常规康复)和观察组(基于运动负荷试验指导下的有氧康复运动),每组45例,康复干预3个月。观察比较两组患者的运动量、血流动力学参数、心理状态。结果:两组患者康复前运动量对比,差异无统计学意义(P>0.05);康复后观察组运动量、运动时间、最大心率、心率血压乘积显著高于对照组,差异具有统计学意义(P<0.05);两组患者康复前每搏输出量(SV)、心输出量(CO)比较,差异无统计学意义(P>0.05);康复后观察组SV、CO均较对照组高,差异具有统计学意义(P<0.05);康复前两组汉密尔顿焦虑量表(HAMA)评分对比,差异无统计学意义(P>0.05);康复后HAMA评分均降低,且观察组低于对照组,差异具有统计学意义(P<0.05)。结论:采用基于运动负荷试验指导下的有氧康复运动对治疗心肌梗死患者具有较好的治疗效果,不仅可有效提升患者的运动量,而且能改善患者血流动力学指标,减轻患者负性情绪。
Objective: To observe the effect of aerobic rehabilitation exercise under the guidance of exercise stress test in patients with myocardial infarction after percutaneous coronary intervention (PCI). Methods: Ninety patients with myocardial infarction admitted to the Third Affiliated Hospital of Guangzhou Medical University from May 2015 to December 2016 were enrolled in this study. All patients underwent PCI and were randomly divided into control group (routine rehabilitation ) And observation group (based on exercise stress test under the guidance of aerobic exercise), 45 cases in each group, rehabilitation intervention for 3 months. Observe and compare the amount of exercise, hemodynamic parameters and psychological status of the two groups of patients. Results: There was no significant difference between the two groups before exercise (P> 0.05). After rehabilitation, the product of exercise, exercise time, maximum heart rate and heart rate was significantly higher than that of the control group (P < 0.05). There was no significant difference in stroke output (SV) and cardiac output (CO) between two groups before rehabilitation (P> 0.05). After rehabilitation, the SV and CO in the observation group were higher than those in the control group (P <0.05). There was no significant difference in Hamilton Anxiety Scale (HAMA) scores between the two groups before rehabilitation (P> 0.05). HAMA scores decreased after the rehabilitation, and the scores in the observation group were lower than those in the control group Statistically significant (P <0.05). Conclusion: The aerobic rehabilitation exercise based on the exercise stress test has a good therapeutic effect on patients with myocardial infarction, which can not only effectively improve the patient’s physical activity, but also improve the hemodynamic parameters and reduce the negative emotions.