CAJ | 학술논문

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.
배경:20세기80년대국내즉개시료급성심기경사적강복치료,단재시급의원인기조건적한제개전득불보편.목적:탐토시급의원심내과실시3주강복간예대급성심기경사환자적가능성.설계:분조대조、회고성분석.단위:영구시중심의원심내과.대상:선택1996년영구시중심의원심내과수입적급성심기경사환자60례위실험조,선택1986년해원수입적급성심기경사환자58례위대조조.실험조남44례,녀16례,년령34～79세,유심공능불전화심솔실상자45례,대조조례수여실험조기본접근.실험조간예중10례출현흉민증상,3례불감접수,경감호급교육균삼가화완성료실험과정.방법:대조조부진행합리적림상치료조시.실험조재실시치료조시적동시,채용급성심기경사3주강복정서진행조활동、조리상、조출원적강복치료.강복정서준수순서점진축점증가운동량화작정개체화원칙,의조환자년령、병정、심리상태등정황가이조정.여출현과부하지정,잠시정지활동혹감소활동강도.주요관찰지표:량조환자3주후운동내량급운동회복시간화환자주원시간적비교.결과:실험조환자전부완성료3주강복간예.실험조급성심기경사후3주운동내량체5～6운동당량자교대조조다(78%,12%,P＜0.05).능상하루자교대조조다(83%,7%,P＜0.05),주원일＜3주자비대조조다(78%,10%,P＜0.05).결론:재시급의원개전급성심기경사적강복정서간예시가행화안전적,조기강복활동가명현가쾌심기경사환자적회복과정.
BACKGROUND: The rehabilitation treatment for acute myocardial infarction has started since 1980' s, but it has not been popularized yet in municipal hospitals due to limited conditions.OBJECTIVE: To probe into the possibility of 3-week rehabilitation intervention in patients with acute myocardial infarction implemented in municipal hospitals.DESIGN: Controlled retrospective analysis was designed.SETTING: Department of Cardiology of YingKou Center Hospital.PARTICIPANTS: Sixty cases of acute myocardial infarction were collected in Department of Cardiology of Center Hospital in Yingkou City in 1996 and they were taken as experimental group. Totally 58 cases of acute myocardial infarction hospitalized in 1986 were taken as the control. In experimental group, 44 cases were males and 16 cases females, aged varied from 34 to 79 years; of which, 45 cases were diagnosed as cardiac dysfunction and cardiac arrhythmia. The situation in the control was near basically to that in experimental group. During the intervention, in experimental group, 10 cases presented chest oppression, 3 cases were afraid to accept the intervention; but by monitoring and explanation, all of those accomplished the experiment.METHODS: In the control, only rational clinical management was given. In experimental group, at the same time of clinical management implemented,the rehabilitation treatment for 3 weeks was carried out for patients with acute myocardial infarction, aiming to earlier movement, earlier getting up, earlier discharge. The rehabilitation procedure stood by gradually increased exercise amount and individualization and it was adjusted according to age, situation of sickness and psychological state, etc. For instance, if the signs of over-endurance presented, the exercise would stop temporarily or the exercise intensity be reduced.MAIN OUTCOME MEASURES: Comparisons of exercise endurance, recovery time of exercise and hospitalizing time in 3 weeks of two groups.RESULTS: The patients in experimental group all accomplished 3-week rehabilitation intervention. In experimental group, the cases, in which, the exercise endurance was up to 5 to 6 equivalents 3 weeks after acute myocardial infarction, were more than the control (78%, 12%, P ＜ 0.05). The cases that were able to go up-down stairs were more than the control(83%, 7%, P＜ 0.05) . The cases hospitalized ＜ 3 weeks were more than the control (78%, 10%, P ＜0.05).CONCLUSION: It is practical and safe to carry on rehabilitation procedure for acute myocardial infarction in municipal hospital. Rehabilitation exercise at the early stage accelerates remarkably the recovery of acute myocardial infarction.