冠心病患者出院后一年运动康复现状调查

发布时间：2018-07-21 10:08

【摘要】：目的:通过调查分析保定市三甲医院出院后一年的冠心病人群运动康复的现状,为今后开展心脏康复,特别是社区、家庭环境中有效开展心脏运动康复提供依据。方法:本研究以2015年《冠心病患者运动治疗中国专家共识》为依据制定《冠心病患者运动状况调查问卷》,采用定点连续抽样的方法,选取曾于2015年3月--8月期间在保定市三所三级甲等医院接受治疗的494名冠心病患者,对其进行出院一年后运动康复状况的横断面调查。从中选取知情同意且主观自我评价运动强度为“中等运动强度”的患者,利用心肺运动测试系统在其日常运动中对其进行客观运动强度检测,以进一步了解冠心病患者的实际运动现状。采用SPSS20.0统计软件完成数据录入与统计分析,对运动状况及相关内容知晓状况的分布情况主要采用描述性统计分析,对可能影响患者运动参与状况的一般资料采用卡方检验。结果:1.问卷调查中,出院一年后冠心病患者运动锻炼参与率为71.7%。参与运动锻炼的人群中:98.5%的患者仅进行有氧运动而未合并抗阻运动;74.8%的患者主观自我评价日常运动为低强度运动,25.2%的患者主观自我评价日常运动为中等强度运动;运动频率达到3-5次/周的人群比例为41.6%;运动持续时间达到20-60分钟/次的人群比例为57.7%;20.6%的患者在运动开始和结束时会进行热身和放松运动;能够正确了解硝酸甘油使用方法的患者为58.5%;运动中急救药品携带率为23%;所有患者在进行运动康复前均未接受过专业的运动风险评估与运动能力评价以及专业的运动指导。2.共40位主观自我评价日常运动强度为“中等强度”的患者接受了客观运动强度检测。其中有2人(5%)和4人(10%)的客观运动强度高于、低于“客观中等运动强度”上限和下限(60%HRR/40%HRR)。在客观运动强度维持在个体中等强度范围的条件下,患者平均相对运动强度为48.1±4.5HRR%。在客观运动强度达到个体中等强度的条件下,患者的平均绝对运动强度4.6±0.6Mets。达到个体无氧阈强度的人数比例为19%。结论:所调查的冠心病人群中,出院一年后运动锻炼行为与2015年《冠心病运动治疗中国专家共识》中提出的运动处方相关内容相比,在运动形式、运动强度、运动持续时间、运动频率、运动中急救药品携带、硝酸甘油的正确使用以及接受运动指导等内容上与《共识》的推荐标准存在差距。仅重视有氧运动而忽略抗阻运动以及有氧运动的客观强度较低是当前冠心病患者运动康复中最为突出的两大问题,这可能会明显削弱冠心病患者的运动获益,可能是导致冠心病患者远期预后不良的重要因素之一。运动作为心脏康复的基础手段,需要临床和社区专业人员给予专门的指导,即为患者提供专门的运动处方,强调运动方式、运动强度、运动持续时间、运动频率和注意事项,使冠心病患者的运动康复科学、规范的进行。特别需要关注抗阻运动的开展,并保证有氧运动的运动强度达标,从而使冠心病患者从运动中获益。
[Abstract]:Objective: through the investigation and analysis of the current situation of the movement rehabilitation of the coronary heart disease population in the first year after discharge in Baoding three a hospital, to provide the basis for the heart rehabilitation, especially in the community and in the family environment. Methods: This study was based on the Chinese expert consensus of "coronary heart disease" in 2015. The exercise status questionnaire was used to select 494 coronary heart disease patients who had been treated in three grade three grade A hospitals in Baoding city during --8 month of March 2015. A cross-sectional survey of exercise rehabilitation after one year of discharge was carried out. In order to further understand the actual movement of the patients with coronary heart disease, the cardiopulmonary exercise test system was used to detect the actual movement of coronary heart disease. The SPSS20.0 statistical software was used to complete the data entry and statistical analysis, and the distribution of the state of awareness of the movement and related contents was carried out by the cardiopulmonary exercise test system. Descriptive statistical analysis was used to analyze the general data that may affect the participation of patients. Results: in the 1. questionnaire survey, one year after discharge, the participation rate of coronary heart disease patients was 71.7%. involved in exercise: 98.5% of the patients only performed aerobic exercise without anti resistance exercise; 74.8% of the patients were not involved in the exercise. The subjective self-evaluation of daily exercise was low intensity exercise, and 25.2% of the patients had subjective self evaluation of moderate intensity exercise; the rate of 3-5 times per week was 41.6%, and the proportion of people with a duration of 20-60 minutes / times was 57.7%; 20.6% of the patients were warmer and relaxed at the beginning and end of the exercise. The patients who were able to understand the use of nitroglycerin correctly were 58.5%, and the first aid drug carrying rate in exercise was 23%. All patients had not received professional exercise risk assessment, exercise ability evaluation and professional exercise guidance.2. before exercise rehabilitation, and 40 subjective self I evaluated daily exercise intensity as "medium intensity". The patients received objective exercise intensity test. The objective exercise intensity of 2 (5%) and 4 (10%) was higher than that of "objective moderate exercise intensity" upper limit and lower limit (60%HRR/40%HRR). The average relative motion intensity of the patient was 48.1 + 4.5HRR%. at the objective movement intensity under the condition that the objective exercise intensity was maintained at the medium intensity range. The ratio of the average absolute exercise intensity of 4.6 + 0.6Mets. to the individual anaerobic threshold was 19%.. The exercise behavior in the coronary heart disease population was compared with the exercise prescription related to the Chinese expert consensus of the 2015 coronary heart disease exercise therapy. In the form of exercise, the intensity of exercise, the duration of exercise, the frequency of exercise, the carrying of first-aid drugs in the exercise, the correct use of nitroglycerin, and the acceptance of exercise guidance, there is a gap between the recommendations of the "consensus >". The two most prominent problems in dynamic rehabilitation may obviously weaken the exercise benefit of patients with coronary heart disease, which may be one of the important factors that lead to poor prognosis in patients with coronary heart disease. As a basic means of heart rehabilitation, exercise should be given by clinical and community professionals to provide special exercise prescriptions for patients. It emphasizes sports, exercise intensity, duration of exercise, movement frequency and attention, which makes the exercise rehabilitation of coronary heart disease patients scientific and standardized. We should pay special attention to the development of resistance movement and ensure that the intensity of aerobic exercise is up to the standard, so that the patients of coronary heart disease can benefit from the exercise.
【学位授予单位】：河北大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.5

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