运动康复联合心理治疗对冠心病经皮冠状动脉介入治疗术后老年患者的影响被引量：49

Effects of exercise rehabilitation combined with psychotherapy in elderly patients with coronary heart disease after percutaneous coronary intervention

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摘要目的探讨运动康复联合心理治疗相对单纯运动康复对冠心病经皮冠状动脉介入治疗(PCI)术后老年患者的影响。方法选取我院收治的老年冠心病PCI术后患者150例,年龄均在65岁以上,采用随机方法分为A组(常规药物治疗)、B组(常规药物治疗+运动康复治疗)和C组(常规药物治疗+运动康复治疗+心理治疗),每组各50例,B、C组患者均于术后2周进行干预,每周1次,共12周。观察3组患者汉密顿焦虑量表(HAMD)评分、汉密顿抑郁量表(HAMA)评分、左心室射血分数、6 min步行试验、代谢当量治疗前后的改变及各组之间的差异。结果治疗前,B组代谢当量(3.58±0.14)均低于A组(3.69±0.18)和C组(3.68±0.15),A组和C组无差别。治疗12周后,HAMA评分A组干预前后(12.98±2.51)分和(12.16±2.91)分无差别(P>0.05),B组(12.90±2.12)分和(8.06±2.11)分、C组(13.03±2.52)分和(6.96±2.13)分均较治疗前降低(P<0.05);HAMD评分各组均较治疗前降低[治疗前后:A组(22.38±2.52)分和(20.87±2.12)分,B组(22.58±2.57)分和(17.25±2.32)分,C组(22.23±2.35)分和(13.39±2.25分,且C组下降比B、A组均更为显著,B组下降显著于A组(P<0.05)];左心室射血分数[治疗前后:A组(49.08±1.59)%和(52.15±1.91)%,B组(48.99±2.11)%和(57.56±2.13)%,C组(49.04±2.02)%和(59.92±1.93)%]、6 min步行试验(m)[治疗前后:A组(360.78±12.50)m和(370.16±12.41)m,B组(359.21±10.54)m和(394.19±15.56)m,C组(363.12±15.28)m和(413.29±18.15)m]、代谢当量(METs)[治疗前后:A组(3.69±0.18)和(3.91±0.21),B组(3.58±0.14)和(4.89±0.09),C组(3.68±0.15)和(5.77±0.13)],较治疗前比较各组均有提高,且C组均高于B、A组,B组高于A组(P<0.05)。结论运动康复联合心理治疗对冠心病PCI术后老年患者的身体状况改善有重要意义,且优于单纯常规运动康复。 Objective To investigate the effect of exercise rehabilitation combined with psychotherapy and exercise rehabilitationn alone in elderly patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI).Methods A total of 150 elderly patients(≥65 years)admitted to our hospital with CHD after primary PCI were enrolled and randomly divided into the group A(conventional drug therapy),group B(conventional drug therapy+exercise rehabilitation)and group C(conventional drug therapy+exercise rehabilitation+psychotherapy),with 50 patients in each group.Patients in groups B and C were intervened at two weeks after PCI,once a week for 12 weeks.Changes of Hamilton anxiety scale(HAMD)scores,Hamilton depression scale(HAMA)score,6 min walking test,left ventricular ejection fraction(LVEF)and metabolic equivalents(METs)were compared among the three groups.Results Before treatment,the METs were significantly lower in the group B(3.58±0.14)compared with the groups A(3.69±0.18)and C(3.68±0.15),and were similar between groups A and C.After 12 weeks of treatment,compared with the indicators before treatment,the HAMA scores were similar in the group A(12.98±2.51 vs.12.16±2.91,P>0.05),and were significantly decreased in groups B(12.90±2.12 vs.8.06±2.11,P<0.05)and C(13.03±2.52 vs.6.96±2.13,P<0.05);HAMD scores were all markedly decreased in all three groups(group A:22.38±2.52 vs.20.87±2.12;group B:22.58±2.57 vs.17.25±2.32;group C:22.23±2.35 vs.13.39±2.25),and were decreased most in the group B,followed by groups A and B(P<0.05).Furthermore,the LVEF group A:(49.08±1.59)%vs.(52.15±1.91)%;group B:(48.99±2.11)%vs.(57.56±2.13)%;group C:(49.04±2.02)%vs.(59.92±1.93)%,6 min walking distance test(m)(group A:360.78±12.50 vs.370.16±12.41;group B:359.21±10.54 vs.394.19±15.56;group C:363.12±15.28 vs.413.29±18.15)and METs(group A:3.69±0.18 vs.3.91±0.21;group B:3.58±0.14 vs.4.89±0.09;group C:3.68±0.15 vs.5.77±0.13)were significantly improved in all groups after the treatment.Among them,group C was improved most,followed by groups B and A(all P<0.05).Conclusions Exercise rehabilitation combined with psychotherapy is of great significance to improve the physical condition of elderly patients with CHD after PCI,and it is better than the routine exercise rehabilitation alone.

作者王杏芬高永红张羽松 Wang Xingfen;Gao Yonghong;Zhang Yusong(Department of Elder Comprehensive Internal,Beijing Aerospace General Hospital,Beijing 100076,China;Department of Cardiology,Tongren City People’s Hospital,Guizhou Tongren 554300,China)

机构地区北京航天总医院干部医疗科贵州省铜仁市人民医院心内科

出处《中华老年医学杂志》 CAS CSCD 北大核心 2020年第5期514-517,共4页 Chinese Journal of Geriatrics

基金北京市丰台区卫生计生系统科研项目(2017-44)。

关键词运动康复心理疗法血管成形术经腔经皮冠状动脉 Exercise rehabilitation Angioplasty transluminal percutaneous coronary

分类号 R473.5 [医药卫生—护理学]

作者简介通信作者:张羽松,Email:zhangyusong168@163.com。

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参考文献2

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