心肌梗塞后患者心脏康复的最新方法

Hanna Strakolyst, Anatolii Altukhov, Anastasiya Salivon-Goncharenko
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摘要

文章探讨了根据欧洲心脏病学会的最新规定,为心肌梗塞后患者实施多模式心脏康复计划的可能性。据悉,心肌梗塞是导致人们体力活动受限、丧失工作能力、残疾和猝死的主要原因。这项研究的目的是为心肌梗塞后患者制定多模式心脏康复计划,并评估其有效性。研究材料和方法包括:分析研究课题的科学和方法文献;分析医疗文件;研究心血管系统功能状态的方法;间歇性增加负荷的自行车测力测试;博格知觉劳累量表;医院焦虑和抑郁量表(HADS);数理统计方法。研究结果结果表明,在多模式心脏康复治疗的影响下,干预结束时主要群体患者的几乎所有调查指标都有显著增加。根据纽约心脏协会(NYHA)的分类,在 6 分钟测试中行走距离(米)的增加使大多数患者的心功能不全等级转为 II 级。间歇性增加负荷的自行车测力测试显示,主要受试者群体的机体总体耐力有所提高,并与 6MWT 指标相关。根据医院焦虑和抑郁量表(HADS),心肌梗塞后患者在运动时的主观感受有所改善,焦虑、情感障碍和抑郁明显减少。在对照组中,只有 6MWT 指标有显著提高,这表明心血管系统的适应能力有所提高,而受测者机体的整体耐力并没有提高。结论根据心肌梗塞患者的最新干预方案,采用多模式的心脏康复方法将大大有助于优化心血管系统,使患者更快地恢复完整的生活。
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Up-to-date approach to cardiorehabilitation of post-myocardial infarction persons
The article considers the possibility of using a multimodal cardiorehabilitation program for post-myocardial infarction people in accordance with the updated Regulations of the European Society of Cardiology. It is noted that myocardial infarction is the main cause of limitation of physical activity, loss of working capacity, disability and sudden death among the population. The purpose of the study is to develop of a multimodal cardiorehabilitation program for post-myocardial infarction people and to evaluate its effectiveness. Research material and methods are: analysis of scientific and methodological literature by the research topic; analysis of medical documentation; methods of researching the functional state of the cardiovascular system; bicycle ergometric test with intermittently increasing load; Borg Rating of Perceived Exertion Scale; Hospital Anxiety and Depression Scale (HADS); methods of mathematical statistics. The results. It is shown that under the impact of multimodal cardiorehabilitation, in the main group of patients at the end of the intervention, there is a significant increase in almost all the investigated indicators. An increase in the traveled distance (m) in the 6-minute test according to the classification of the New York Heart Association (NYHA) made it possible to transfer the majority of patients to the II functional class of cardiac insufficiency. A bicycle ergometric test with an intermittently increasing load showed an increase in the overall endurance of the organism of the main group of tested people and correlated with the 6MWT indicators. The subjective feelings of post-myocardial infarction patients during exercise, which were evaluated by the 10-point Borg Rating of Perceived Exertion Scale, improved, and a significant decrease in anxiety, emotional disorders, and depression according to the Hospital Anxiety and Depression Scale (HADS) was noted. In the control group, there was a significant increase only in the 6MWT indicator, which indicates an increase in the adaptive capabilities of the cardiovascular system, and not an increase in the overall endurance of the organism of the tested people. Conclusions. A multimodal approach to cardiorehabilitation in the light of updated intervention protocols for patients with myocardial infarction will significantly contribute to the optimization of the cardiovascular system and the faster return of patients to a full life.
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