Buerger运动在下肢动脉硬化闭塞症腔内治疗术后病人中的应用

发布时间：2018-06-26 21:53

本文选题：buerger运动 + 下肢动脉硬化闭塞症　；参考：《吉林大学》2017年硕士论文

【摘要】：目的:探讨buerger运动对下肢动脉硬化闭塞症病人股乆动脉行支架术后患侧肢体血液循环、支架通畅率及术后患者生活质量的影响。方法:选取2016年1月-2016年10月在吉林大学第一医院行下肢股乆动脉支架的100例患者随机分为对照组50例,其中男性42例,女性8例,干预组50例,男性44例,女性6例。两组患者均接受常规的出院指导及随访,由责任护士进行,包括用药指导、饮食指导、心理护理、运动指导,比如散步、打太极拳等,不能进行剧烈活动,比如踢足球、打篮球等。干预组在此基础上,不仅由责任护士进行上述指导外,还由研究者本人给予buerger运动指导。教会患者本人及同住家属此运动的方法,运动频次及注意事项等。并在出院后一周、每个月给予电话随访监督buerger运动完成情况。比较两组患者出院后3个月、6个月患侧肢体踝肱指数值、侧支循环形成情况、支架的通畅率,及出院后6个月两组患者的生活质量。结果:将两组患者一般资料(年龄、性别、吸烟史、合并症)进行比较,差异无统计学意义(P0.05),具有可比性。两组患者出院后3个月、6个月踝肱指数(ABI)值的比较:干预组较对照组在出院后3个月、6个月ABI值都有明显提高,差异有统计学意义(P0.001)。两组患者出院后3个月、6个月侧支循环形成比较:两组患者出院后3个月患侧肢体侧支循环形成比较无统计学意义;出院后6个月干预组侧支循环形成较对照组有所提高,差异有统计学意义(P0.05)。两组患者出院后3个月、6个月支架通畅率的比较:两组患者支架通畅率在出院后3个月、6个月比较,差异无统计学意义。两组患者生活质量的比较:出院后6个月,干预组的生理机能、一般健康状况、精神健康评分均高于对照组,差异有统计学意义(P0.05);干预组自身干预前后比较(除情感职能和精力)均明显改善,差异有统计学意义(P0.05);对照组自身前后比较,生理职能、躯体疼痛、一般状况、社会功能有所改善,差异有统计学意义(P0.05)。结论:1.buerger运动能提高下肢动脉硬化闭塞症病人股乆动脉行支架术后患侧肢体血液循环;2.buerger运动对改善下肢动脉硬化闭塞症病人术后股乆动脉支架通畅率效果并不明显;3.buerger运动能提高下肢动脉硬化闭塞症病人股乆动脉行支架术后患者的生活质量。但在情感职能及精力方面改善效果并不明显。
[Abstract]:Objective: to investigate the effect of buerger exercise on blood circulation, patency rate of stents and quality of life of patients with arteriosclerotic obliteration of lower extremity after stenting. Methods: from January 2016 to October 2016, 100 patients with femoral stents were randomly divided into control group (n = 42), female (n = 8), intervention group (n = 50), male (n = 44) and female (n = 6). The patients in both groups received routine discharge guidance and follow-up, including medication guidance, diet guidance, psychological care, exercise guidance, such as walking, Taijiquan, etc., and were not able to engage in strenuous activities, such as playing football. Play basketball, etc. On this basis, the intervention group was guided not only by the responsible nurses, but also by the researcher himself. The method, frequency and attention of this exercise are taught to the patients themselves and their family members. The completion of buerger exercise was monitored by telephone follow-up one week after discharge. The values of ankle-brachial index, collateral circulation, the patency rate of stents and the quality of life of the two groups were compared 3 and 6 months after discharge. Results: the general data (age, sex, smoking history, complications) of the two groups were compared, the difference was not statistically significant (P0.05), comparable. Comparison of ankle brachial index (ABI) between the two groups at 3 and 6 months after discharge: the ABI values in the intervention group were significantly higher than those in the control group at 3 and 6 months after discharge (P0.001). There was no significant difference between the two groups in the formation of collateral circulation in the affected limbs 3 months after discharge and 6 months after discharge, and the formation of collateral circulation in the intervention group was higher than that in the control group at 6 months after discharge, and there was no significant difference in the formation of collateral circulation between the two groups at 3 months and 6 months after discharge. The difference was statistically significant (P0.05). Comparison of stent patency rate between the two groups at 3 and 6 months after discharge: there was no significant difference in stent patency rate between the two groups at 3 months and 6 months after discharge. Comparison of quality of life between the two groups: 6 months after discharge, the physiological function, general health status, mental health score of the intervention group were higher than those of the control group. The difference was statistically significant (P0.05); the intervention group before and after intervention (except emotional function and energy) significantly improved, the difference was statistically significant (P0.05); the control group before and after comparison, physiological functions, body pain, general status, Social function improved, the difference was statistically significant (P0.05). Conclusion 1. Buerger exercise can improve the blood circulation of the affected limb after stenting in patients with arteriosclerosis obliterans of lower extremities. 2. Buerger exercise can improve the patency rate of stents of femoral arteries in patients with arteriosclerosis obliterans of lower extremity after operation. Buerger exercise can improve the quality of life of patients with lower extremity arteriosclerosis obliterans after stenting. But the effect of improvement in emotional function and energy is not obvious.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R543.5

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