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《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:

期数:

2024年06期

页码:

975-979

栏目:

临床研究

出版日期:

2024-12-25

文章信息/Info

Title:

-

作者:

司茹雅¹; 吕向妮¹; 何 霞²; 卢瑞萍¹; 张 婷¹

710032 西安,空军军医大学第一附属医院心血管外科¹
710032 西安,空军军医大学第一附属医院康复理疗科²

Author(s):

-

关键词:

心脏瓣膜置换术;  呼吸肌训练;  心肺康复运动;  肺功能;  运动耐力

Keywords:

-

分类号:

R563

DOI:

10.3877/cma.j.issn.1674-6902.2024.06.023

摘要:

目的 分析呼吸肌训练(respiratory muscle training, RMT)联合阶段性心肺康复运动(cardiopulmonary rehabilitation exercise, CRE)对心脏瓣膜置换术(heart valve replacement, HVR)后肺功能及运动耐力的影响。方法 选取2022年1月至2024年1月我院收治的经心脏瓣膜置换手术患者73例。随机分为观察组36例,对照组37例。对照组给予常规治疗及RMT,观察组在此基础上增加CRE。采用三酰甘油(triacylglycerol, TG),总胆固醇(total cholesterol, TC)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol, HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol, LDL-C)、无氧代谢阈值(anaerobic threshold, AT)、代谢当量(metabolic equivalent, METs)和峰值摄氧量(peak oxygen uptake, VO₂max)、用力肺活量(forced vital capacity, FVC)、左心室射血分数(left ventricular ejection fraction, LVEF)及6 min步行试验等判断两组治疗前后的肺功能和运动耐力,采用简明健康状况调查表评价生活质量。结果 两组心脏瓣膜置换术后经呼吸肌训练与阶段性心肺康复治疗前相比,差异无统计学意义(P>0.05)。观察组治疗后,HDL-C(1.47±0.24)mmol/L、 LDL-C(2.11±0.43)mmol/L、TG(1.53±0.07)mmol/L、TC(2.06±0.34)mmol/L低于对照组(1.86±0.04)mmol/L、(3.35±0.65)mmol/L、(2.39±0.16)mmol/L、(3.62±1.31)mmol/L; 观察组AT(15.61±0.55)ml? kg^-1?min^-1、METs(6.49±0.49)L?kg^-1?min^-1、FVC(85.14±2.25)ml/m²、VO₂max(19.46±1.93)ml?kg^-1?min^-1高于对照组(13.58±1.19)ml?kg^-1?min^-1、(6.25±0.35)L?kg^-1?min^-1、(82.48±2.20)ml/m²、(18.45±1.61)ml? kg^-1?min^-1,观察组LVEF(53.12±6.11)%低于对照组(62.06±7.49)%; 观察组6 min步行距离(604.88±25.14)m高于对照组(543.22±32.80)m; 观察组SF-36维度分值,包括生理功能(86.51±4.93)分、生理职能(88.34±3.45)分、躯体功能(87.63±5.34)分、生命力(82.97±4.67)分、社会功能(86.77±5.00)分、情感职能(88.46±4.81)分、心理健康(86.77±5.01)分、总体健康(88.46±4.81)分高于对照组(81.86±3.14)分、(82.11±3.51)分、(77.83±3.97)分、(79.54±3.32)分、(79.11±3.73)分、(83.03±2.91)分、(79.11±3.71)分、(83.03±2.91)分,两组患者有明显改善(P<0.05)。结论 RMT联合CRE改善HVR后肺功能和运动耐力,具有临床意义。

Abstract:

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备注/Memo

备注/Memo:

基金项目: 国家自然科学基金项目(82000373)
通信作者: 吕向妮, Email: 306263372@qq.com

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更新日期/Last Update: 2024-12-25