[1]周召锋,吴春阳,杨红莹,等.冠心病PCI术后中西医结合心脏康复模式的探讨[J].徐州医科大学学报,2020,40(11):830-833.[doi:10.3969/j.issn.2096-3882.2020.11.011]
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冠心病PCI术后中西医结合心脏康复模式的探讨()
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《徐州医科大学学报》[ISSN:2096-3882/CN:32-1875/R]

卷:
40
期数:
2020年11期
页码:
830-833
栏目:
出版日期:
2020-11-25

文章信息/Info

Title:
Exploration of the Cardiac Rehabilitation Model Based on Integrated Traditional Chinese and Western Medicine Following PCI for Coronary Heart Disease
作者:
周召锋 吴春阳 杨红莹 施亚明 王斌 陈荣敏 李学美 张诚霖
盐城市第三人民医院心内科,江苏 盐城224001;黄海社区卫生服务中心,江苏 盐城224001
关键词:
经皮冠状动脉介入治疗 中西医结合心脏康复 分级诊疗
DOI:
10.3969/j.issn.2096-3882.2020.11.011
文献标志码:
A
摘要:
目的 对冠心病经皮冠状动脉介入治疗术(PCI)后患者进行三级医院指导下的社区中西医结合心脏康复,初步探讨该模式的有效性.方法 将首次行PCI治疗的冠心病患者95例,按随机原则分为常规治疗组(对照组,46例)和心脏康复组(康复组,49例).对照组给予冠心病的常规二级预防治疗,康复组给予三级医院指导下的社区中西医结合心脏康复治疗,2组均随访6个月.收集2组患者基线资料和干预后6个月的6分钟步行试验(6MWT)距离、左室射血分数(LVEF)、N末端B型利钠肽原(NT-proBNP)水平、焦虑评分(PHQ-9量表)、抑郁评分(GAD-7量表)、主要心脏不良事件(MACE)的发生率及因胸部不适及焦虑等原因再入院率.结果 康复组干预6个月后的6MWT距离明显大于对照组,NT-proBNP水平明显低于对照组,差异均有统计学意义(P<0.05).康复组干预6个月后的焦虑评分较干预前明显下降,差异有统计学意义(P<0.05);对照组干预前后对比,差异无统计学意义(P>0.05).干预6个月后,对照组总MACE事件、心肌梗死、再次血运重建的发生率虽较康复组有所增加,但差异无统计学意义(P均>0.05).康复组较对照组患者再入院率低,差异有统计学意义(P<0.05).在整个康复过程中未发生运动意外伤害及运动相关的心血管事件.结论 对冠心病PCI术后患者实施三级医院指导下的社区中西医结合心脏康复,安全、有效且可行,值得进一步观察研究.
Abstract:
Objective To preliminarily explore the effectiveness and suitability of community cardiac rehabilitation based on integrated traditional Chinese and Western medicine under the guidance of third-grade hospitals for patients who have undergone percutaneous coronary intervention (PCI) for coronary heart disease (CHD).Methods Ninety-five patients initially treated with PCI for CHD were randomly assigned to the conventional treatment group (N=46) or cardiac rehabilitation group (N=49). The conventional treatment group received conventional treatment for secondary prevention of CHD; the cardiac rehabilitation group received community cardiac rehabilitation based on integrated traditional Chinese and Western medicine under the guidance of third-grade hospitals; both groups were followed up for 6 months. Six-Minute Walk Distance (6MWD), left ventricular ejection fraction (LVEF), N-terminal pro b-type natriuretic peptide (NT-proBNP)PHQ-9 score, GAD-7 score, incidence of major adverse cardiovascular events (MACEs), as well as the rate of readmission due to chest discomfort and anxiety, etc., were collected from patients in both groups at baseline and at 6 months of intervention.Results At 6 months of intervention, 6MWD was significantly longer, and NT-proBNP was significantly lower in the rehabilitation group than in the control group, with statistically significant differences(t=4.710,t=2.031,P<0.05). At 6 months of intervention, PHQ-9 score decreased significantly from baseline in the rehabilitation group, with statistically significant difference(t=2.910,P<0.05), while there was no statistically significant change from baseline in PHQ-9 score in the control group(t=1.611,P>0.05). At 6 months of intervention, the incidences of overall MACEs, myocardial infarction, and repeat revascularization increased in the control group compared to the rehabilitation group; however the differences were not statistically significant (all P>0.05) ; the readmission rate was lower in the rehabilitation group than in the control group, with statistically significant difference(χ2 =4.146,P<0.05). No accidental injuries from exercise or exercise-related cardiovascular events were reported throughout the rehabilitation process. Conclusion For patients who have undergone PCI for CHD, community cardiac rehabilitation based on integrated traditional Chinese and Western medicine under the guidance of third-grade hospitals is safe, effective and feasible, warranting further observational studies.
更新日期/Last Update: 2020-12-15