Karaszewski Daniel
Klinika Kardiochirurgii, I Katedra i Klinika Kardiologii, Warszawski Uniwersytet Medyczny.
Kardiochir Torakochirurgia Pol. 2014 Mar;11(1):86-9. doi: 10.5114/kitp.2014.41940. Epub 2014 Mar 27.
Taking into consideration the rise in ischemic heart disease and the increasing number of performed cardiac surgery procedures, attempts have been made to prepare an optimal rehabilitation program enabling the effective improvement of patient condition in the shortest possible time-frame that would be of most benefit for the patients [1, 2].
Aim of the study was to compare the therapeutic efficacy of two rehabilitation models (I - a modified model, and II - the standard cardiac rehabilitation model of the Polish Cardiac Society) during early hospitalization in patients after coronary artery bypass graft surgery (CABG).
Between December 2011 and April 2012, the study examined 42 men (aged 48-76) who underwent myocardial revascularization at the Clinic of Cardiac Surgery of the 1(st) Chair and Clinic of Cardiology of the Medical University of Warsaw. The patients were randomly assigned to one of two groups: A (model I) and B (model II), with 21 patients in each group. The qualification process for the procedures was planned, the postoperative course was uneventful, and the patients were discharged from the ward as normal (between the 7(th) and 10(th) postoperative day). In order to compare the two employed models, a 6-minute walk test was conducted during the 7(th) day of postoperative rehabilitation.
Differences between the study groups were revealed with regard to heart rate values (group A - mean heart rate before the test: 78 bpm, after the test: 82 bpm; group B - mean heart rate before the test: 82 bpm, after the test: 87 bpm) and perceived exertion (group A - mean exertion level: 0.5 points, group B - mean exertion level: 0.7 points).
The modified rehabilitation model exerts a better therapeutic effect on the patients than the standard one. The introduced modifications are safe, as the applied physical exertion is well tolerated by patients.
考虑到缺血性心脏病的发病率上升以及心脏外科手术数量的增加，人们尝试制定一个最佳康复计划，以便在尽可能短的时间内有效改善患者状况，这将对患者最为有益[1,2]。
本研究的目的是比较两种康复模式（模式I - 改良模式，模式II - 波兰心脏病学会的标准心脏康复模式）在冠状动脉搭桥术（CABG）后患者早期住院期间的治疗效果。
2011年12月至2012年4月期间，该研究对42名男性（年龄48 - 76岁）进行了检查，这些患者在华沙医科大学第一心脏外科诊所和心脏病学诊所接受了心肌血运重建术。患者被随机分为两组：A组（模式I）和B组（模式II），每组21名患者。手术的资格认定过程是经过规划的，术后过程顺利，患者正常出院（术后第7至10天之间）。为了比较所采用的两种模式，在术后康复第7天进行了6分钟步行测试。
研究组在心率值（A组 - 测试前平均心率：78次/分钟，测试后：82次/分钟；B组 - 测试前平均心率：82次/分钟，测试后：87次/分钟）和主观用力程度（A组 - 平均用力水平：0.5分，B组 - 平均用力水平：0.7分）方面存在差异。
改良康复模式对患者的治疗效果优于标准模式。所引入的改良是安全的，因为患者对所施加的体力活动耐受性良好。
