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目的观察意大利某康复中心冠心病老年患者介入治疗后经综合康复训练配合心理治疗对其预后的影响。方法挑选出22例确诊为冠心病并成功进行了首次PCI的患者。临床上采用常规的药物疗法(口服硝酸酯类、肠溶阿司匹林、转换酶抑制剂等)。患者在院整个治疗过程都有专业的心理医生进行心理指导或治疗。患者并于术后3d开始进行不同阶段、不同运动强度的康复训练。3个疗程(约12周)后,行心电图活动平板运动试验[1]。观察活动平板运动试验运动前、运动中的心率、血压、心电图改变及心绞痛发作情况。结果经康复治疗3个疗程后,患者运动时心率较治疗前有所下降,总康复训练时间有明显延长(P<0.05);治疗后患者活动平板运动试验中运动至心绞痛出现时间比治疗前明显延长(P<0.05或P<0.01)、最大运动耐量明显增加(P<0.05)。结论经过系统综合的康复训练和心理治疗冠心病介入术后患者的运动耐量明显提高,心绞痛等临床症状明显缓解。
Objective To observe the effect of comprehensive rehabilitation training and psychotherapy on the prognosis of elderly patients with coronary heart disease in a rehabilitation center in Italy. Methods Twenty-two patients who were diagnosed with coronary heart disease and successfully performed the first PCI were selected. Clinically, conventional pharmacotherapy (oral nitrates, enteric-coated aspirin, conversion enzyme inhibitors, etc.) is used. Patients in the hospital throughout the course of treatment have a professional psychiatrist for psychological guidance or treatment. Patients and at 3d after the start of different stages, different exercise intensity of rehabilitation training. After 3 courses (about 12 weeks), electrocardiogram treadmill exercise test [1]. Observation of treadmill exercise test before exercise, exercise, heart rate, blood pressure, ECG changes and angina pectoris. Results After 3 cycles of rehabilitation, the heart rate of the patients during exercise decreased compared with that before treatment, and the total rehabilitation training time was significantly longer (P <0.05). After exercise, the time from exercise to angina pectoris in patients with treadmill exercise was significantly longer than that before treatment (P <0.05 or P <0.01), and the maximum exercise tolerance increased significantly (P <0.05). Conclusion After comprehensive systematic rehabilitation training and psychotherapy, patients with exercise-induced coronary heart disease have significantly improved their exercise tolerance, and their clinical symptoms such as angina pectoris have been significantly alleviated.