CAJ | 학술논문

目的：观察Ⅰ期心脏康复治疗促进冠状动脉旁路移植（ CABG）术后患者恢复的临床疗效。方法选取2010-06-01至2010-10-02在中国医科大学附属第一医院心脏外科行CABG术患者40例，采用随机交替的方法将其分为康复组和对照组，各20例。两组患者均给予CABG术后常规护理，其中，康复组在此基础上提供以运动疗法为核心的心脏康复治疗，包括运动疗法、呼吸训练、心脏危险因素控制、疾病教育以及心理咨询等术后早期康复策略。患者均于术前及术后第15天进行生活质量即健康调查简表（ SF-36）评定及6分钟步行试验。结果术前，两组患者生理机能（ PF）、生理职能（ RP）、躯体疼痛（ BP）、一般健康状况（ GH）、精力（ VT）、社会功能（ SF）、情感职能（RE）、精神健康（MH）评分比较，差异均无统计学意义（P>0.05）；康复治疗后，康复组PF、GH、VT、MH评分高于对照组（P<0.05）。两组康复治疗后PF、BP、GH评分均高于术前，康复组康复治疗后VT、MH评分均高于术前（P<0.05）。两组患者术前6分钟步行试验行走距离、静息心率、峰值心率、变化心率比较，差异均无统计学意义（P>0.05）；康复治疗后，康复组6分钟步行试验行走距离长于对照组，峰值心率、变化心率均低于对照组（ P<0.05）。两组康复治疗后6分钟步行试验行走距离均长于术前，康复组康复治疗后峰值心率、变化心率均低于术前（P <0.05）。结论Ⅰ期心脏康复可以有效改善 CABG术后患者恢复情况，并且不会增加心脏事件风险，值得临床推广应用。
목적：관찰Ⅰ기심장강복치료촉진관상동맥방로이식（ CABG）술후환자회복적림상료효。방법선취2010-06-01지2010-10-02재중국의과대학부속제일의원심장외과행CABG술환자40례，채용수궤교체적방법장기분위강복조화대조조，각20례。량조환자균급여CABG술후상규호리，기중，강복조재차기출상제공이운동요법위핵심적심장강복치료，포괄운동요법、호흡훈련、심장위험인소공제、질병교육이급심리자순등술후조기강복책략。환자균우술전급술후제15천진행생활질량즉건강조사간표（ SF-36）평정급6분종보행시험。결과술전，량조환자생리궤능（ PF）、생리직능（ RP）、구체동통（ BP）、일반건강상황（ GH）、정력（ VT）、사회공능（ SF）、정감직능（RE）、정신건강（MH）평분비교，차이균무통계학의의（P>0.05）；강복치료후，강복조PF、GH、VT、MH평분고우대조조（P<0.05）。량조강복치료후PF、BP、GH평분균고우술전，강복조강복치료후VT、MH평분균고우술전（P<0.05）。량조환자술전6분종보행시험행주거리、정식심솔、봉치심솔、변화심솔비교，차이균무통계학의의（P>0.05）；강복치료후，강복조6분종보행시험행주거리장우대조조，봉치심솔、변화심솔균저우대조조（ P<0.05）。량조강복치료후6분종보행시험행주거리균장우술전，강복조강복치료후봉치심솔、변화심솔균저우술전（P <0.05）。결론Ⅰ기심장강복가이유효개선 CABG술후환자회복정황，병차불회증가심장사건풍험，치득림상추엄응용。
Objective To evaluate the clinical effect of phase-one cardiac rehabilitation on the recovery of patients after coronary artery bypass grafting ( CABG ). Methods We enrolled 40 patients who received CABG in the department of cardiac surgery of the First Hospital of China Medical University from June 1 to October 2 in 2010. Using alternate-random order method,the subjects were divided into rehabilitation group and control group,each group 20 subjects. The two groups were both administrated with conventional care after CABG,while the rehabilitation group was also given cardiac rehabilitation treatment which included kinesitherapy, respiratory training, and control of risk factors for heart disease, disease education and psychological consultation,with kinesitherapy as the central regimen. Before surgery and on day 15 after surgery,the life quality of the subjects was evaluated by SF-36,and 6-minute walk test was also conducted. Results Before surgery,the two groups were not significantly different(P>0. 05)in PF,RP,BP,GH,VT,SF,RE and MH;after rehabilitation,rehabilitation group was higher(P<0. 05)than control group in the scores of PF,GH,VT and MH. The two groups had higher(P <0. 05)scores of PF,BP and GH than those before surgery,and rehabilitation group had higher(P<0. 05)scores of VT and MH than those before surgery. Before surgery,the two groups were not significantly different(P>0. 05)in the results of 6-minute walk test,resting heart rate,peak heart rate and the changing of heart rate;after rehabilitation,the rehabilitation group had longer(P<0. 05)walking distance than control group in 6 -minute walk test and was lower(P <0. 05)than control group in peak heart rate and the changing of heart rate. The two groups had longer(P<0. 05)walking distance in 6-minute walk test,lower peak heart rate(P<0. 05)and less changing of heart rate(P<0. 05)after rehabilitation than those before rehabilitation. Conclusion One-phase cardiac rehabilitation could effectively improve the recovery of patients after CABG and does not increase risk in cardiac events. One-phase cardiac rehabilitation is recommendable for promotion and application.