心肺运动试验动态指导下的康复策略在心肌梗死介入术后患者中的应用

Application of rehabilitation strategies guided by dynamic cardiopulmonary exercise testing in patients after interventional therapy for myocardial infarction

  • 摘要:
    目的 探讨心肺运动试验(CPET)动态指导下的康复策略在心肌梗死介入术后患者中的应用价值。
    方法 选取96例心肌梗死介入术后患者为研究对象, 并根据入院顺序分为对照组(n=48)和观察组(n=48)。对照组采用传统心脏康复策略,观察组采用CPET动态指导下的康复策略。比较2组遵医率、不良事件发生率。比较2组术前、术后的峰值摄氧量、无氧阈摄氧量、左心室射血分数(LVEF)、6 min步行距离(6 MWT)以及运动自我效能感量表(SEE)评分和中国心血管病人生活质量评定问卷(CQQC)评分。
    结果 术后3个月,观察组遵医率为87.50%, 高于对照组的68.75%, 差异有统计学意义(P < 0.05)。术后1、3个月,观察组的LVEF、峰值摄氧量、无氧阈摄氧量、SEE评分及6 MWT高于或大于对照组,差异有统计学意义(P < 0.05)。术后3个月,观察组CQQC各项评分高于对照组,差异有统计学意义(P < 0.05)。术后3个月,观察组的不良事件发生率为4.17%, 低于对照组的18.75%, 差异有统计学意义(P < 0.05)。
    结论 CPET动态指导下的康复策略在心肌梗死介入术后患者中的应用价值较高,有助于其建立遵医行为,改善心肺功能及生活质量,以及降低不良事件发生率。

     

    Abstract:
    Objective To explore the application value of rehabilitation strategies guided by cardiopulmonary exercise testing (CPET) in patients after interventional therapy for myocardial infarction.
    Methods A total of 96 patients after interventional therapy for myocardial infarction were selected as study subjects and divided into control group (n=48) and observation group (n=48) according to the order of admission. The control group received traditional cardiac rehabilitation strategies, while the observation group received rehabilitation strategies guided by dynamic CPET. The medication compliance rate and the incidence of adverse events were compared between the two groups. Peak oxygen uptake, anaerobic threshold, left ventricular ejection fraction (LVEF), 6-minute walk test (6MWT) distance, scores of the Self-Efficacy for Exercise (SEE) and the Chinese Quality of Life Questionnaire for Cardiovascular Patients (CQQC) were compared between the two groups before and after surgery.
    Results Three months after surgery, the medication compliance rate in the observation group was 87.50%, which was significantly higher than 68.75% in the control group (P < 0.05). At 1 month and 3 months after surgery, the LVEF, peak oxygen uptake, anaerobic threshold, SEE score and 6MWT distance in the observation group were significantly higher or larger than those in the control group (P < 0.05). Three months after surgery, the scores of the CQQC in the observation group were significantly higher than those in the control group (P < 0.05). Three months after surgery, the incidence of adverse events in the observation group was 4.17%, which was significantly lower than 18.75% in the control group (P < 0.05).
    Conclusion The rehabilitation strategies guided by dynamic CPET have high application value in patients after interventional therapy for myocardial infarction, helping them establish medication compliance behavior, improve cardiopulmonary function and quality of life, and reduce the incidence of adverse events.

     

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