心脏康复促进冠状动脉搭桥术后患者体能恢复及不良情绪改善
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辽宁省教育厅高等学校科学技术研究项目(20060977)


The Effects of Rehabilitation on Improving the Physical Capacity and Ameliorating Emotional Disorders in Patients of Coronary Artery Bypass Grafting
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    目的观察心脏康复治疗对冠状动脉搭桥术后患者运动功能及不良情绪的改善作用。方法心脏外科拟行冠状动脉搭桥手术患者52例,将其随机分为康复组及对照组。两组患者均接受常规治疗,康复组在上述基础同时给予运动训练及心理干预。于术前、术后15天对入选患者进行6 min步行实验(6MWT)、左心室射血分数、汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评定。结果与对照组比较,术后15天康复组患者6MWT明显提高(298.15±59.24 m比220.80±54.25 m,p<0.01), HAMA及HAMD评分显著降低(2.07±2.45分比5.48±3.32分及2.26±2.31分比6.36±3.81分,p<0.01)。与术前比较,康复组术后左心室射血分数也有改善(p<0.01);进一步分析发现,患者手术前后6MWT差值与手术前后HAMA及HAMD评分差值具有负相关性(r=-0.53,p<0.01;r=-0.60,p<0.01)。 结论心理干预联合运动训练对冠状动脉搭桥术后患者不良情绪改善及运动能力恢复均有促进作用,值得临床推广应用。

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    AimTo investigate the role of cardiac rehabilitation on improving exercise capacity and ameliorating emotional disorders in coronary artery bypass grafting patients.MethodsFifty-two patients who had to wait for coronary artery bypass grafting (CABG) in the 1st hospital of China medical university were randomly divided into cardiac rehabilitation group(n= 27) and usual care group(control, n=25).All of the patients received conventional therapy,and the rehabilitation group was treated by gradually increased exercise and psychological intervention.6 min walk test,left ventricular ejection fraction(LVEF), hamilton anxiety scale(HAMA), self-rating depress scale(HAMD) were measured in preoperative and on 15th postoperative day.ResultsOn 15th postoperative day,compared with control group, 6-min walk distance of rehabilitation group was significantly higher(298.15±59.24 m vs 220.80±54.25 m, p<0.01), and the scores of HAMA, HAMD significantly dropped(2.07±2.45 scores vs 5.48±3.32 scores,2.26±2.31 scores vs 6.36±3.81 scores,p<0.01), rehabilitation patient’s postoperative LVEF was improved compared with preoperative(p<0.01).With futher analysis, the rehabilitation group showed a negative correlation between HAMA(r=-0.53,p<0.01),HAMD(r=-0.60,p<0.01) level and 6-min walk distance respectively.ConclusionsPsychological intervention combined with exercise treatment to patients undergoing coronary artery bypass grafting may drop levels of anxiety and depression, improve exercise capacity.It deserves further clinical applications.

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马跃文,刘畅,朱佳琪,何曼.心脏康复促进冠状动脉搭桥术后患者体能恢复及不良情绪改善[J].中国动脉硬化杂志,2012,20(6):536~540.

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  • 收稿日期:2011-08-08
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