微创医学

目的探讨抗阻训练配合有氧运动方案应用于急性心肌梗死（AMI）患者经皮冠状动脉介入（PCI）术后的康复效果。方法选择106例AMI患者为研究对象，其中PCI术后行常规康复锻炼的51例患者设为对照组，同期接受常规康复锻炼联合抗阻训练及有氧运动，且一般资料与对照组均衡可比的55例患者设为观察组。比较两组患者的左室射血分数（LVEF）、左室收缩末期内径（LVESD）、左室舒张末期内径（LVEDD），以及6分钟步行距离（6MWD），术后生活自理能力（Barthel指数量表）评分及生活质量（SF-36）评分。结果 PCI术后3 d，两组患者的LVEF、LVESD、LVEDD，以及6MWD比较，差异均无统计学意义（均P＞0.05）；PCI术后6个月，两组患者的LVEF、6MWD明显增加，LVESD、LVEDD明显变小，且观察组LVEF、6MWD水平明显高于对照组，LVESD、LVEDD明显小于对照组，差异均有统计学意义（均P＜0.05）。术后3 d，两组患者的Barthel指数量表评分比较，差异无统计学意义（P＞0.05）；出院前及术后6个月，两组患者的Barthel指数量表评分均明显增高，且观察组高于对照组，差异均有统计学意义（均P＜0.05）。术后6个月，观察组患者SF-36量表的生理功能、躯体疼痛、躯体角色、活力、心理健康、社会功能、一般健康状况、情感角色领域的评分均明显高于对照组，差异均有统计学意义（均P＜0.05）。结论 AMI患者PCI术后给予抗阻训练联合有氧运动，能够有效改善患者的心功能、运动功能和生活自理能力，提高术后生活质量。

Objective To explore the rehabilitation effect of resistance training combined with aerobic exercise in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Methods A total of 106 AMI patients were selected as the research objects. Among them, 51 patients who underwent routine rehabilitation exercise after PCI were set as the control group. At the same time, 55 patients who received routine rehabilitation exercise combined with resistance training and aerobic exercise, and whose general data were comparable to those of the control group were set as the observation group. The left ventricular ejection fraction (LVEF), left ventricular end-systolic dimension (LVESD), left ventricular end-diastolic dimension (LVEDD), 6-minute walk distance (6MWD), postoperative self-care ability (Barthel index scale) score and quality of life (SF-36) score were compared between the two groups. Results There were no statistically significant differences in LVEF, LVESD, LVEDD, and 6MWD between the two groups 3 days after PCI (all P＞0.05). Six months after PCI, LVEF and 6MWD increased significantly, LVESD and LVEDD decreased significantly in both groups, and LVEF and 6 MWD of the observation group were significantly higher than those of the control group, LVESD and LVEDD were significantly smaller than those of the control group, with statistically significant differences (all P＜0.05). There was no statistically significant difference in Barthel index scale score between the two groups 3 days after operation (P＞0.05). Before discharge and 6 months after operation, the scores of Barthel index scale in the two groups were significantly increased, and the observation group was higher than the control group, with statistically significant differences (all P＜0.05). Six months after operation, the scores of SF-36 in the observation group were significantly higher than those in the control group in terms of physiological function, physical pain, role-physical, vitality, mental health, social function, general health status and expressive role, with statistically significant differences (all P＜0.05). Conclusion The combination of resistance training and aerobic exercise in AMI patients after PCI can effectively improve their cardiac function, motor function and self-care ability, and improve their postoperative quality of life.