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。%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.
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