刘华、刘遂心.住院期康复治疗对心脏外科手术后患者运动能力的影响[J].中华物理医学与康复杂志,2016,38(4):287-291
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| 住院期康复治疗对心脏外科手术后患者运动能力的影响 |
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| DOI： |
| 中文关键词: 心脏外科手术 心脏康复 运动能力 踏步试验 |
| 英文关键词: Cardiac surgery Cardiac rehabilitation Exercise capacity Step test |
| 基金项目:湖南省发展和改革委员会科研项目（20121521） |
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| 中文摘要: |
| 目的 探讨住院期心脏康复对心脏外科手术后患者运动能力的影响。 方法 纳入符合标准的心脏瓣膜病和冠心病患者42例，按随机数字表法分成康复组（22例）和对照组（20例）。对照组在常规治疗的基础上，予以术前教育和术前呼吸指导；康复组在对照组的基础上，行住院期心脏康复治疗。2组干预前后均行2min踏步试验（2-MST）及左室射血分数（LVEF）测定，观察2组患者的住院时间。出院1个月后电话随访，用退伍军人特定活动问卷（VSAQ）估测2组患者出院1个月后的运动能力。 结果 干预后，2组患者左室射血分数分别为（53.73±9.29）%和（56.25±11.01）%，组间差异无统计学意义(P>0.05）。康复组出院时2min踏步次数［（79.41±10.99）次］明显高于对照组［(71.25±14.21)次］，差异有统计学意义(P<0.05）；出院1个月后康复组的运动能力METs（5.77±1.46）也显著高于对照组(4.75±1.34)METs，组间差异有统计学意义(P<0.05）。出院时2min踏步次数与入院时2min踏步次数呈正相关（r=0.869，P<0.01），出院1个月后运动能力与入院时2min踏步次数呈正相关（r=0.752，P<0.01）。康复组的住院时间［（15.59±3.08）d］较对照组显著缩短［（18.45±3.63）d］，差异有统计学意义(P<0.01）。 结论 住院期心脏康复可以明显改善心脏外科手术后患者的运动能力，缩短住院时间；2min踏步试验方法简单且实用，可用于心脏外科手术后患者早期运动能力评估。 |
| 英文摘要: |
| Objective To explore the effect of an in-hospital cardiac rehabilitation program on exercise capacity after cardiac surgery. Methods Forty-two patients with valvular heart disease or coronary heart disease were recruited and randomly divided into a rehabilitation group (n=22) and a control group (n=20). Both groups were given preoperative education and breathing guidance on the basis of conventional clinical treatment, but the rehabilitation group was also provided with in-hospital cardiac rehabilitation after the operation. The two-minute stepping test (2-MST) and the left ventricular ejection fraction test (LVEF) were performed before and after the intervention for both groups. Their hospital stays were also compared. One month after discharge, the exercise capacity of both groups was followed-up by telephone using the Veterans-specific Activity Questionnaire (VSAQ). Results After the intervention, there was no significant difference in average LVEF between the two groups (53.73±9.29% and 56.25±11.01% respectively). The average 2-MST stepping frequency of the rehabilitation group was significantly greater than the control group (79.41±10.99 times and 71.25±14.21 times respectively, P<0.05). One month after discharge, the exercise capacity of the rehabilitation group was also significantly higher than the control group for (5.77±1.46 METs versus 4.75±1.34 METs, P<0.05). Stepping frequency at discharge and exercise capacity at one month after discharge were both positively correlated to 2-MST stepping frequency at admission（r=0.869, P<0.01; r=0.752, P<0.01). The average hospital stay of the rehabilitation group was significantly shorter (by about 3 days) than the control group (15.59±3.08 days versus 18.45±3.63 days, P<0.01). Conclusions In-hospital cardiac rehabilitation can significantly improve exercise capacity after cardiac surgery and reduce the length of hospital stays. The 2-minute step test is a simple and practical way to assess the exercise capacity of patients early after cardiac surgery. |
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