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山东大学学报(医学版)

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老年冠心病心衰患者运动康复治疗中心理干预的临床意义

姜红梅1,2,陈文强1   

  1. 1.山东大学齐鲁医院心内科, 山东 济南 250012; 2.枣庄市立第二医院老年康复科, 山东 枣庄 277103
  • 收稿日期:2013-09-29 出版日期:2014-04-10 发布日期:2014-04-10
  • 通讯作者: 陈文强 E-mail:chenwenqiang33@sina.com

Clinical implication of psychotherapy on elderly patients with coronary heart failure undergoing rehabilitation

JIANG Hongmei1,2, CHEN Wenqiang1   

  1. 1. Department of Cardiology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China;
    2. Department of Geriatric Rehabilitation, Second Hospital of Zaozhuang City, Zaozhuang 277103, Shandong, China
  • Received:2013-09-29 Online:2014-04-10 Published:2014-04-10

摘要: 目的  探讨老年冠心病心衰患者运动康复治疗中的心理干预作用。方法  82例老年冠心病心衰患者随机分为对照组和心理干预组,均给予正规的心衰药物治疗及专业康复运动训练,干预组同时接受正规的心理治疗。采用HAMD、HAMA进行评定,监测血压、心率、血糖、血脂、左室射血分数(LVEF)及6min步行距离等,于治疗4周及6个月后分别予以评定。结果  入组时两组肯定抑郁者为53例(64.6%),肯定焦虑者为36例(43.9%);4周及6个月后干预组HAMD评分均低于对照组(P<0.05);4周后两组患者的心率、血脂、6min步行距离以及LVEF较治疗前均显著改善;6个月后干预组上述指标改善更为明显,与对照组比较有统计学差异。结论  心理治疗能有效改善老年冠心病心衰患者运动康复治疗中的负性情绪,改善心功能。

关键词: 运动康复, 心理干预, 冠心病, 心力衰竭

Abstract: Objective  To investigate the psychological status of elderly patients with coronary heart failure who underwent rehabilitation therapy and psychological intervention. Methods  A total of 82 hospitalized elderly patients with coronary heart disease were randomly divided into two groups: the intervention group and control group. All patients received drug therapy for heart failure and rehabilitation exercise training under the guidance of rehabilitation therapist. The patients in the intervention group also received psychological treatments. HAMD and HAMA scores were evaluated. Blood pressure, heart rate, blood glucose and lipid profiles, left ventricular ejection factor (LVEF) and 6-minute walking distance were monitored at the baseline, 4 weeks and 6 months after treatments, respectively. Results  There were 53 depression cases (64.6%) and 36 anxiety cases (43.9%) in the two groups. After 4 weeks and 6 months of treatments, the HAMD scores of the intervention group were significantly lower than those of the control group (all P<0.05). Six-minute walking distance of the intervention group was significantly longer than that of the control group after 4 weeks of treatment. Blood pressure, heart rate, lipid profiles, 6-minute walking distance and cardiac function were improved markedly in the intervention group than in the control group after 6 months of treatment. Conclusion  Psychological therapy can effectively correct the negative emotion and improve heart function of elderly patients with coronary heart failure undergoing rehabilitation therapy.

Key words: Psychological intervention, Heart failure, Coronary heart disease, Exercise rehabilitation

中图分类号: 

  • R543.3
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