Efficiency analysis of early cardiac rehabilitation procedures in treating patients after percutaneous coronary intervention
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摘要:目的 探讨早期心脏康复程序在经皮冠状动脉介入术后患者中的应用效果。方法 将2016年8月—2017年8月行常规干预的经皮冠状动脉介入术后患者51例作为对照组, 将2017年9月—2018年9月行早期心脏康复程序干预的经皮冠状动脉介入术后患者51例作为观察组。比较2组干预前后心功能水平、生存质量，比较2组术后6个月内心血管不良事件发生率。结果 观察组干预2周后左心室射血分数(LVEF)高于对照组，左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)和室壁运动积分指数(WMSI)水平低于对照组，差异有统计学意义(P < 0.05)。观察组干预2周后生理机能、躯体疼痛、生理职能、情感职能、社会功能、精力、一般健康状况、精神健康评分均显著高于对照组(P < 0.05)。观察组恶性心律失常发生率显著低于对照组(P < 0.05)。结论 早期心脏康复程序可改善经皮冠状动脉介入术后患者的心功能水平，提高生存质量，减少心血管不良事件发生。Abstract:Objective To investigate the efficicy of early cardiac rehabilitation procedures in treating patients after percutaneous coronary intervention.Methods From August 2016 to August 2017, 51 patients underwent routine intervention forpercutaneous coronary intervention were selected as control group. From September 2017 to September 2018, 51 patients with early cardiac rehabilitation procedures for percutaneous coronary intervention were selected as observation group. The cardiac function before and after treatment, quality of life and the incidence rate of adverse cardiovascular events after 6 months of operation were compared between two groups.Results After 2 weeks of intervention, the left ventricular ejection fraction (LVEF) in the observation group was significantly higher than that in the control group, and the levels of left ventricular end-systolic volume (LVESV), left ventricular end-diastolic volume (LVEDV) and wall motion integral index (WMSI) were significantly lower than those in the control group (P < 0.05). After 2 weeks of intervention, the scores of physiological function, physical pain, physiological function, emotional function, social function, energy, general health status and mental health in the observation group were significantly higher than those in the control group (P < 0.05). The incidence rate of malignant arrhythmia in the observation group was significantly lower than that in the control group (P < 0.05).Conclusion Early cardiac rehabilitation procedures can improve cardiac function of patients with percutaneous coronary intervention, improve quality of life, and reduce cardiovascular adverse events.
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表 1 2组干预前后心功能水平比较(x±s)
时点 组别 LVEF/% LVESV/mL LVEDV/mL WMSI 干预前 对照组(n=51) 58.27±9.75 47.25±4.93 28.15±4.04 2.33±0.73 观察组(n=51) 58.45±9.82 47.19±5.01 28.09±3.89 2.37±0.78 干预2周后 对照组(n=51) 62.17±9.22 42.16±4.82 26.73±4.02 2.13±0.84 观察组(n=51) 69.85±6.82* 36.26±4.28* 22.15±3.94* 1.37±0.46* LVEF: 左心室射血分数; LVESV: 左心室收缩末期容积; LVEDV: 左心室舒张末期容积; WMSI: 室壁运动积分指数。与对照组比较, *P < 0.05。 
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表 2 2组干预前后生存质量比较(x±s)
分 时点 组别 生理机能 躯体疼痛 生理职能 情感职能 社会功能 精力 一般健康状况 精神健康 干预前 对照组(n=51) 62.37±10.55 54.39±10.32 55.78±9.44 49.37±8.44 62.38±8.47 51.62±8.44 55.36±9.33 55.48±9.31 观察组(n=51) 62.51±10.78 54.18±10.54 55.12±9.93 49.17±8.26 62.95±8.62 51.27±9.03 55.42±9.64 55.52±9.25 干预2周后 对照组(n=51) 66.37±8.25 60.29±9.83 60.29±8.62 54.27±10.25 70.35±8.47 55.71±8.63 59.12±7.51 60.41±9.03 观察组(n=51) 75.38±8.78* 71.38±9.55* 68.34±8.11* 62.35±9.61* 78.37±9.11* 64.11±8.55* 68.44±8.32* 74.28±8.15* 与对照组比较, *P < 0.05。
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表 3 2组心血管不良事件发生率比较[n(%)]
组别 心力衰竭 心绞痛 恶性心律失常 对照组(n=51) 1(1.96) 4(7.84) 15(29.41) 观察组(n=51) 0 1(1.96) 2(3.92)* 与对照组比较, *P < 0.05。
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