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Ⅰ期心脏康复对急性ST段抬高型心肌梗死急诊PCI术后患者心功能的影响

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目的 探讨Ⅰ期心脏康复对急性ST段抬高型心肌梗死(STEMI)急诊经皮冠状动脉介入治
疗(PCI)后患者心功能的影响。方法 连续入选2017年1月至2018年5月于佛山市第二人民医院CCU收治
的78例STEMI患者,随机分为观察组38例和对照组40例,观察组实施Ⅰ期心脏康复训练,对照组给予传
统的急性心肌梗死PCI后常规护理。结果 两组患者住院期间干预后,观察组左心室每搏做功、心输出
量及6分钟步行试验距离较对照组均显著增加(P均<0.05),两组患者平均动脉压、主要心血管不良事
件(严重心律失常、梗死后心绞痛、心力衰竭)及术口血肿发生率比较,差异均无统计学意义(P均>
0.05)。结论 对急性ST段抬高型心肌梗死急诊PCI后患者实施Ⅰ期心脏康复能改善心功能,提高运动耐
力,且安全可行。

Abstract:

Objective To discuss the influence of phase I cardiac rehabilitation on heart function in patients
with acute ST-segment elevation myocardial infarction (STEMI) after emergent PCI. Methods STEMI patients
(n=78) were chosen continuously from CCU of the Second People’s Hospital of Foshan City from Jan. 2017 to May
2018, and divided randomly into observation group (n=38) and control group (n=40). The observation group was
given phase I cardiac rehabilitation and control group was given traditional routine nursing for acute myocardial
infarction (AMI) after PCI. Results After the intervention during hospitalization, the levels of left ventricular
strove work, cardiac output (CO) and 6-minute walk distance (6MWD) increased significantly in observation
group compared with control group (all P<0.05). The comparison in the level of mean arterial pressure (MAP) and
incidence of major adverse cardiovascular events (MACE, including severe arrhythmia, post-infarction angina
pectoris and heart failure) and hematoma around wound between 2 groups showed the difference had no statistical
significance (all P>0.05). Conclusion The implement of phase I cardiac rehabilitation can improve heart function,
promote exercise tolerance and is safe and feasibility in STEMI patients after emergent PCI.

基金项目:

广东省佛山市科技局基金立项项目(201308026);佛 山市医学重点专科培育项目(Fspy3-2015020);佛山市十三五医学重点 专科和特色专科建设(FSZDZK135024);佛山市卫生和计划生育局医 学科研课题项目(20180099)

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