吸气肌训练对经皮冠状动脉介入治疗术后患者的影响研究

doi:10.3761/j.issn.0254-1769.2020.04.008

摘要/Abstract

摘要： 目的探讨吸气肌训练对急性心肌梗死行经皮冠状动脉介入治疗术后患者心肺功能和运动能力的影响。方法将99例接受经皮冠状动脉介入治疗术的患者随机分为试验组（50例）和对照组（49例）, 试验组在7 d心脏康复运动程序的基础上增加吸气肌训练, 对照组按照7 d心脏康复运动程序进行康复训练。采用最大吸气压和5次坐立试验在患者术后、干预后7 d、出院后4周时进行效果评价, 采用6 min步行试验和心肺运动试验指标评价出院后4周时心肺功能改善程度。结果相比对照组, 试验组在干预7 d、出院后4周时最大吸气压增加, 5次坐立试验时间减少, 重复测量方差分析结果显示, 最大吸气压和5次坐立试验时间效应、组间效应、交互效应的比较, 差异均具有统计学意义（P<0.05）;出院后4周, 试验组与对照组6 min步行试验、峰值耗氧量、氧摄取效率斜率的比较, 差异具有统计学意义（P<0.05）。结论急性心肌梗死经皮冠状动脉介入治疗术后患者在常规心脏康复的同时, 增加吸气肌训练可以提升患者的心肺功能。

关键词: 吸气肌训练, 经皮冠状动脉介入治疗术后, 心肺功能, 护理

Abstract: Objective To explore the effects of inspiratory muscle training on cardiopulmonary function and exercise capacity in patients with acute myocardial infarction after percutaneous coronary intervention（PCI）.Methods 99 patients receiving PCI were randomly allocated into a control group（49 cases） and an intervention group（50 cases）. The control group was only given a 7-day cardiac rehabilitation program, while the intervention group was added with the inspiratory muscle training on this basis. The maximum inspiratory pressure（MIP） and the Five-Times-Sit-to-Stand Test（FTSST） were used to evaluate the effectiveness of the interventions at post-baseline, 7 days after intervention, and 4 weeks after discharge. 6-minute walk test（6MWT） and cardiopulmonary exercise testing were used to evaluate the improvement of cardiopulmonary function at 4 weeks after discharge.Results The results of MIP and FTSST showed improvement in the intervention group and the control group after 7 days of intervention and 4 weeks after discharge. The improvement in the intervention group was better than that in the control group at 4 weeks after discharge（MIP increased 20.22%, 9.31%, and FTSST time decreased respectively 15.64%, 4.75%）.The results of ANOVA for repeated measurement are also statistically significant;there were statistical differences in the 6MWT, peak oxygen consumption, and oxygen uptake efficiency slope between the intervention group and the control group at 4 weeks after discharge（P<0.05）.Conclusion Routine cardiac rehabilitation and the inspiratory muscle training can improve the cardiopulmonary function and exercise capacity in patients with acute myocardial infarction after PCI.

Key words: Inspiratory Muscle Training, Percutaneous Coronary Intervention, Cardiopulmonary Function, Nursing Care

段俊滔, 刘聪颖, 于桂香, 童素梅, 徐顺霖. 吸气肌训练对经皮冠状动脉介入治疗术后患者的影响研究[J]. 中华护理杂志, 2020, 55(4): 519-523.

DUAN Juntao, LIU Congying, YU Guixiang, TONG Sumei, XU Shunlin. Effects of inspiratory muscle training on cardiopulmonary function and exercise capacity of patients after percutaneous coronary intervention[J]. Chinese Journal of Nursing, 2020, 55(4): 519-523.

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