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背景:20世纪80年代国内即开始了急性心肌梗死的康复治疗,但在市级医院因其条件的限制开展得不普遍。目的:探讨市级医院心内科实施3周康复干预对急性心肌梗死患者的可能性。设计:分组对照、回顾性分析。单位:营口市中心医院心内科。对象:选择1996年营口市中心医院心内科收入的急性心肌梗死患者60例为实验组,选择1986年该院收入的急性心肌梗死患者58例为对照组。实验组男44例,女16例,年龄34～79岁,有心功能不全和心率失常者45例,对照组例数与实验组基本接近。实验组干预中10例出现胸闷症状,3例不敢接受,经监护及教育均参加和完成了实验过程。方法:对照组仅进行合理的临床治疗措施。实验组在实施治疗措施的同时,采用急性心肌梗死3周康复程序进行早活动、早离床、早出院的康复治疗。康复程序遵守循序渐进逐渐增加运动量和酌情个体化原则,依照患者年龄、病情、心理状态等情况加以调整。如出现过负荷指征,暂时停止活动或减少活动强度。主要观察指标:两组患者3周后运动耐量及运动恢复时间和患者住院时间的比较。结果:实验组患者全部完成了3周康复干预。实验组急性心肌梗死后3周运动耐量达5～6运动当量者较对照组多(78%,12%,P<0.05)。能上下楼者较对照组多(83%,7%,P<0.05),住院日<3周者比对照组多(78%,10%,P<0.05)。结论:在市级医院开展急性心肌梗死的康复程序干预是可行和安全的,早期康复活动可明显加快心肌梗死患者的恢复过程。
Background: Rehabilitation of acute myocardial infarction (AMI) has been started in China in the 1980s, but it is not common in municipal hospitals because of the limitations of its conditions. Objective: To investigate the possibility of 3-week rehabilitation intervention in patients with acute myocardial infarction in the department of cardiology of municipal hospital. Design: group control, retrospective analysis. Unit: Yingkou Central Hospital Department of Cardiology. PARTICIPANTS: Sixty patients with acute myocardial infarction who were admitted to Department of Cardiology of Yingkou Central Hospital in 1996 were selected as the experimental group. Fifty-eight patients with acute myocardial infarction who received the hospital in 1986 were selected as the control group. The experimental group, 44 males and 16 females, aged 34 to 79 years, 45 cases of cardiac insufficiency and heart rate disorders, the control group of cases and the experimental group was basically close. 10 cases of experimental group had chest distress symptoms, 3 cases did not dare to accept, after monitoring and education have participated in and completed the experimental process. Methods: The control group only reasonable clinical treatment measures. The experimental group in the implementation of treatment at the same time, the use of acute myocardial infarction 3 weeks rehabilitation program for early activity, early leave the bed, early discharge rehabilitation. Rehabilitation procedures follow the gradual and orderly increase the amount of exercise and the principle of individual discretion, according to the patient’s age, condition, psychological status and so on to be adjusted. If there is overload indicator, temporarily stop the activity or reduce the activity intensity. MAIN OUTCOME MEASURES: Comparison of exercise tolerance and exercise recovery time and hospital stay after 3 weeks in both groups. Results: All patients in the experimental group completed 3 weeks of rehabilitation intervention. The experimental group 3 weeks after acute myocardial infarction exercise tolerance of 5 to 6 exercise equivalent than the control group (78%, 12%, P <0.05). The number of patients who could go up and down was significantly higher than that of the control group (83%, 7%, P <0.05). The hospitalization days were less than 3 weeks (78%, 10%, P <0.05). CONCLUSION: Interventions of rehabilitation programs for acute myocardial infarction in municipal hospitals are feasible and safe. Early rehabilitation can significantly speed up the recovery process of patients with myocardial infarction.