目的:探讨永久起搏器植入术围手术期进行改良康复训练操的效果及预后.方法:选择123例永久起搏器植入术患者作为研究对象,根据入院时间随机分为康复训练组(63例)和改良康复训练组(60例),比较两组术后4d切口疼痛评分、术后1周训练时间达标率和动作规范性.术后3个月随访患者的术侧肩膀疼痛发生率和以DASH简式评分表评估的患者日常生活功能、患者满意度等,并进行统计学分析.结果:永久起搏器植入术后,与康复训练组比较,改良康复训练组静脉血栓形成(6.35% 比0%)、术侧肩部疼痛(17.5% 比5.0%)发生率及DASH评分[(17.05 ± 4.48)分比(14.02 ± 3.85)分]明显降低(P<0.05或<0.01),患者满意度(85.7% 比96.6%)、训练时间达标率(28.5% 比76.7%)及动作规范率(33.3% 比68.3%)明显提高(P<0.05或<0.01).结论:永久起搏器植入术患者在围手术期行改良康复训练操能显著提高康复训练的效果,减少并发症的发生,同时提高患者的日常生活能力.%Objective:To explore effect of perioperative modified rehabilitation training exercise in patients undergo-ing permanent pacemaker implantation and their prognosis.Methods:A total of 123 patients undergoing permanent pacemaker implantation were enrolled.According their hospitalization time,they were randomly divided into reha-bilitation training group(n=63)and modified rehabilitation training group(n=60).Postoperative 4d incision pain score, training time standard-reaching rate and action specification within one week after surgery were compared between two groups.On third month after surgery,incidence rate of surgical side shoulder pain was followed up,DASH simplified sco-ring table was used to assess daily living capacity and patient satisfaction etc.,and results were statistically analyzed.Re-sults:After permanent pacemaker implantation,compared with rehabilitation training group,there were significant reduc-tions in incidence rates of venous thrombosis(6.35% vs.0%),surgical shoulder pain(17.5% vs.5.0%)and DASH score [(17.05 ± 4.48)scores vs.(14.02 ± 3.85)scores,P<0.05 or <0.01],and significant rise in patient satisfaction(85.7%vs.96.6%),training time standard-reaching rate(28.5% vs.76.7%)and action specification rate(33.3% vs.68.3%) in modified rehabilitation training group,P<0.05 or <0.01. Conclusion:Perioperative modified rehabilitation training exercise can increase effect for rehabilitation training,reduce incidence of complications and improve daily living capacity in patients undergoing permanent pacemaker implantation.
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