家庭自助心脏康复模式在急性冠状动脉综合征患者中的应用

葛雄 王赛 陈辉

[摘要]目的 探讨家庭自助心脏康复模式在急性冠脉综合征（ACS）患者中应用的有效性，研究其对患者生活质量及运动耐量的影响。方法 选取2016年10月～2017年6月咸宁市中心医院、咸宁市第一人民医院和咸宁医学院附属第二医院收治的88例急性冠脉综合征患者作为研究对象。参照随机数字表法将患者分为对照组及康复组，每组各44例。对照组接受非心脏康复专科医生指导下的常规干预，康复组接受三级医院心脏康复医生联合多学科医生共同参与指导下的针对性干预，收集两组患者基线及康复后3个月后的6 min步行距离、心脏康复情况及生活质量。结果 康复组患者经干预后胸闷发作次数低于对照组，射血分数高于对照组，差异有统计学意义（P<0.01）；生理机能、生理职能、躯体疼痛、精力、社会功能、精神健康评分高于对照组，差异有统计学意义（P<0.05）；6 min步行距离长于对照组，差异有统计学意义（P<0.05）。结论 对ACS患者采取有效的家庭心脏康复指导，可以有效控制患者病情，提高患者运动耐量，减少疾病再发风险，改善患者生活质量。

[关键词]家庭自助心脏康复模式；急性冠脉综合征；生活质量；运动耐量

[中图分类号] R541.4 [文献标识码] A [文章编号] 1674-4721（2018）9（a）-0078-04

[Abstract] Objective To explore the efficacy of the family self-help heart rehabilitation model in patients with ACS， to understand the effects on living quality and exercise tolerance of patients. Methods A total of 88 patients treated in Xianning Center hospital， Xianning First People′s Hospital or Xianning Medical School affiliated Second Hospital diagnosed with ACS were selected as subjects from October 2016 to June 2017. They were divided into two groups by the random number table method， with 44 cases in each group. The control group received routine intervention under the guidance of non-cardiac rehabilitation specialists. The rehabilitation group received the targeted intervention under the guidance of cardiac rehabilitation doctors associate with multidisciplinary doctors from the top 3 hospitals. Following parameters including 6-minutes walk distance， cardiac rehabilitation， score of life quality were collected at baseline and after treatment of 3 months. Results After intervention， the chest tightness in the rehabilitation group was lower than that in the control group， and the ejection fraction in the rehabilitation group was higher than that in the control group （P<0.01）. PF， RP， BP， VT， SF， MH scores in the rehabilitation group were higher than those in the control group （P<0.05）. 6-minutes walking distance in the rehabilitation group was longer than that in the control group （P<0.05）. Conclusion Effective family and cardiac rehabilitation guidance for ACS patients can effectively improve the patients′ exercise tolerance， reduce the risk of disease recurrence， improve quality of life.

[Key word] Self-help heart rehabilitation model； Acute coronary syndrome； Quality of life； Exercise tolerance

全球急性冠狀动脉事件注册研究数据显示4年累计心血管死亡率高达22.6%，其中再发心肌梗死高达50.0%[1]。家庭自助心脏康复模式成为加强心血管防控的一道重要突破口，在控制急性冠脉综合征（ACS）患者病情平稳及预防疾病复发方面的地位举足轻重[2]。本研究旨在探讨家庭自助心脏康复模式在ACS患者中应用的有效性，以期为国内家庭自助心脏康复模式在临床中应用提供参考依据。

1资料与方法

1.1一般资料

选取2016年10月～2017年6月湖北省咸宁市三所综合性医院（咸宁市中心医院、咸宁医学院附属第二医院、咸宁市第一人民医院）确诊为ACS的88例患者作为研究对象，将患者参照随机数字表法分为对照组及康复组，每组各44例。……