早期康复干预对急性脑卒中患者生存质量的影响

目的 探讨早期康复干预对脑卒中患者生存质量的影响。方法 将90例脑卒中偏瘫患者随机分为康复组和对照组，均进行常规神经内科药物治疗．康复组加以运动疗法、作业疗法、言语治疗和心理治疗等。在患者人组时和治疗6个月后采用世界卫生组织生存质量评定量表简表（WHOQOL-BREF）中文版对其生存质量（QOL）进行评定。结果 康复组治疗后WHOQOL—BREF各领域的评分及总分与对照组比较，差异均有统计学意义（P〈0．05）；2组治疗前、后总分差值比较，康复组明显优于对照组（P〈0．05）。结论 早期康复干预可以提高急性脑卒中患者的QOL。     

综合性康复治疗对慢性阻塞性肺病缓解期患者生存质量的影响

目的：探讨综合性肺康复治疗对慢性阻塞性肺病（COPD）缓解期患生存质量的影响。方法：35例COPD缓解期患分为肺康复组（n=20)与对照组（n=15)，肺康复组给予体能锻炼，呼吸肌锻炼，氧疗，宣教，心理与行为干预等综合性肺康复治疗措施，对照组仅在门诊取药治疗，利用生存质量（QOL）评分标准分别在治疗前，治疗后第4周，12周，24周，1年时对两组患生存质量评估。结果：肺康复组治疗后其QOL总均分（TMS），社会活动分（F1S），日常生活因子分（F2S），抑郁因子分（F3S），焦虑因子分（F4S）评分较治疗前均有所降低（P＜0．05，P＜0．001），而对照组则差异无显性意义（P＞0．05），结论：综合性的肺康复治疗能改善患的生存质量。     

多学科综合呼吸康复对老年重度慢性阻塞性肺疾病康复效果的研究

目的探讨多学科综合呼吸康复对老年重度慢性阻塞性肺疾病（COPD）的康复效果。方法将30例缓解期老年重度COPD住院患者分成综合呼吸康复组（康复组，20例）和对照组（10例）。康复组采用健康教育、运动训练、服药指导及营养指导等综合康复，对照组采用内科常规用药。治疗前、后2组均评定呼吸困难（采用Borg评分）、生存质量（QOL）、日常生活活动（ADL）、运动耐力（应用6min步行距离，6MWD）和肺功能，并进行组内与组间比较。结果治疗前2组的Borg评分、QOL、ADL、6MWD及肺功能差异无统计学意义（P〉0．05）。治疗3个月后，康复组的Borg评分明显降低，6MWD明显增加，与治疗前比较，差异均有统计学意义（P〈0，01），QOL和ADL也有明显提高，与治疗前比较，差异均有统计学意义（P〈0．05），而肺功能无明显改善。结论多学科综合呼吸康复虽不能使老年重度COPD患者的肺功能得到改善，但能使患者的呼吸困难症状减轻，生存质量提高，运动耐力改善及ADL能力增强。     

早期康复治疗对脊髓损伤患者生存质量的影响

目的探讨早期康复治疗对脊髓损伤患者生存质量（Quality of life,QOL）的影响。方法选择脊髓损伤患者86例,按康复治疗介入的时间分为早期康复组（3个月内就诊）46例和对照组（3个月后就诊）40例,两组均接受常规康复治疗,并对每组患者在入组时和6个月后利用生存质量评定量表（WHOQOL—BREF）中文版对其QOL进行评定。结果与治疗前比较,早期康复组和对照组患者在治疗后的QOL评分均有显著提高（分别提高21．39±6．57;12．53±6．88,P〈0．05）,但治疗后,早期康复组的QOL评分（78．55±8．32）高于对照组（69．98±14．06）,且差异有统计学意义（P〈0．05）。结论早期康复治疗可以提高脊髓损伤患者的生存质量。     

康复护理对急性心肌梗死患者生存质量的影响

目的：探讨康复护理对急性心肌梗死（AMI）患生存质量（QOL）的影响。方法：将138例AMI患随机分为康复组和对照组,分别采用康复护理方案和传统护理方案,随访6个月后对研究对象进行生存质量问卷调查。结果：两组在日常生活与工作,情绪,自觉健康情况,睡眠与性功能4个方面在统计学上有显性差异（P＜0．05）。结论：康复护理可以改善AMI后患的生活质量。     

运动训练对冠心病患者血浆同型半胱氨酸水平的影响

目的探讨运动训练对冠心病患者血浆同型半胱氨酸（Hey）水平的影响。方法将148例冠心病患者分为康复组81例及药物组67例，均给予基础药物治疗和冠心病饮食指导，康复组患者增加运动训练；药物组同时应用叶酸、维生素B。：治疗。结果经12周的治疗，2组Hey水平均明显低于治疗前（P〈0．05）；组间比较，差异无统计学意义（P〉0．05）。康复组心功能及生活质量方面较药物组有明显改善（P〈0．05）。结论心脏康复治疗可明显降低冠心病患者Hey水平，改善心功能状态，提高患者生活质量。     

运动疗法应用于慢性心力衰竭患者的疗效观察

目的：观察运动疗法对慢性心力衰竭（CHF）患者的疗效。方法：对28例CHF患者在常规治疗的基础上．实施运动疗法，并与27例非康复组患者进行对照比较；观察一年以后患者的心功能、运动耐量、生存质量、6min步行距离、再住院率和死亡率。结果：一年后，康复组和对照组比较，心功能改善（P〈0．05）；运动耐量、生存质量、6min步行距离显著改善（P〈0．01）；再住院率降低（P〈0．05）；死亡率未降低（P〉0．05）。结论：运动疗法可以改善心功能。提高运动耐量和生存质量，降低再住院率。     

早期康复治疗对急性心肌梗死患者疗效的影响

目的：探讨早期康复训练对急性心肌梗死患者病情的影响。方法：将122例急性心肌梗死（AMI）低危患者，平行随机分为康复组（62例）和对照组（60例）。两组除予以常规治疗外，康复组采用为期2周，以步行为主的康复训练：结果：两组患者在室性心律失常（Lown≥Ⅲ），梗死延展，心率变异性和Q—T离散度阳性率，差异无显著性意义（P〉0．05）。在入院第3、4周末，进行左心功能测定LVEF≥50％者康复组（66．7％）高于对照组（47．4％），差异有显著性意义（P〈0．01）。第4周末的低水平平板运动试验阳性率，康复组（27．1％）低于对照组（39．1％）（P〈0．05）。住院期间心绞痛、再梗死、死亡率与平均住院天数，康复组均低于对照组（P〈0．05）。结论：对无明显并发症的AMI患者，采取早期康复训练，是安全可行的，有利于病情恢复，提高生存质量。     

早期康复对脑卒中后焦虑、抑郁症状的影响

目的 观察早期康复对脑卒中后焦虑、抑郁症状的影响。方法 137例脑卒中偏瘫患者分为康复组（70例）和对照组（67例），均进行神经内科常规药物治疗，康复组患者同时接受早期康复治疗；对两组患者分别于治疗前和治疗3个月后进行Bathel指数（BI）、Fugl—Meyer运动量表（FMMS）、汉密尔顿抑郁量表（HAMD）和汉密尔顿焦虑量表（HAMA）测试。结果 治疗3个月后，康复组患者的HAMD、HAMA、BI和FMMS、评分与治疗前有显著性差异（P〈0．05～0．01），与对照组治疗后亦有显著性差异（P〈0．05）；对照组的BI、FMMS评分与治疗前有显著性差异（P〈0．05）；康复组抑郁发生率22．86％，焦虑发生率5．71％，对照组分别为40．30％和16．42％．两组间有显著性差异（PG0．05）。结论 早期康复对脑卒中患者的焦虑及抑郁症状有明显的改善作用。     

信息支持对减轻乳腺癌患者术后焦虑状态的相关性研究

目的：探讨信息支持对减轻乳腺癌患者术后焦虑的影响。方法：将106例乳腺癌患者随机分为观察组54例和对照组52例,对照组采用常规护理,观察组在对照组的基础上采用信息支持。使用状态一特质焦虑量表（STAI）测量和自我效能感量表（GSES）比较两组的焦虑评分。结果：观察组状态焦虑量表（SAI）、特质焦虑量表（TAI）评分低于对照组（P〈0．01）,GSES评分高于对照组（P〈0．01,P〈0．05）。结论：信息支持可减轻乳腺癌患者术后焦虑,提高患者的生存质量。     

急性心肌梗死患者10d康复治疗的可行性评估与疗效研究

目的 探讨无合并症的急性心肌梗死(AMI)患者实施10 d住院心脏康复程序的可行性及其疗效.方法 51例AMI患者随机分成两组:10 d康复组:在常规药物治疗基础上实施10 d康复训练；对照组:在常规药物治疗基础上实施2周康复训练.两组患者出院前均以心脏彩超、Holter、汉密顿焦虑量表(HAMA)进行评估.结果 两组患者在住院期间均无死亡、再梗死病例发生；两组患者在心功能、心率变异性(heart rate variability,HRV)及焦虑指数上差异无统计学意义(P＞0.05)；10 d康复组可缩短住院天数.结论 10 d康复方案可缩短患者住院天数,而不增加住院期间的病死率与再梗死率,未见影响心脏结构和功能及心电稳定性的现象.     

运动康复治疗对合并抑郁的急性心肌梗死患者心功能、生活质量及近期预后的影响

目的:运动康复治疗对合并抑郁的急性心肌梗死患者心功能、生活质量及近期预后的影响。方法:选择我院心内科接受治疗的急性心肌梗死患者为研究对象。依据抑郁量表评分分为无抑郁组(A组)和抑郁组(B组),两组各分为常规药物治疗组(A1组和B1组)和常规药物治疗联合运动康复治疗组(A2组和B2组)各60例。对比各组患者心功能及生活质量的改善情况及近期预后。结果:4组患者治疗前生活质量及心功能无统计学差异,治疗8周后A2组患者比A1组、B2组比B1组患者心功能明显改善,生活质量明显提高(均P0.05);且A2与B2组相比,心功能及生活质量改善更明显,差异具有统计学意义(均P0.05)。8周后患者心力衰竭、心源性休克发生率,A2组A1组B1组,A2组B2组B1组,差异且均具有统计学意义(均P0.05);8周内再发心肌梗死率、死亡率各组间差异无统计学意义(P0.05)。结论:抑郁组患者心力衰竭及心源性休克的发生率较无抑郁组高;无论患者是否合并抑郁,运动康复治疗均可减少心力衰竭及心源性休克的发生率;无论患者是否合并抑郁,运动康复治疗均可以改善患者的生活质量及心功能,但是无抑郁组患者改善更明显。     

Physical and psychological improvements after phase II cardiac rehabilitation in patients with myocardial infarction

We have designed a new 4-week hospitalized phase II cardiac rehabilitation program. The purpose of the present study is to clarify whether the physical and psychological status of patients with myocardial infarction (MI) improves after participation in our program. Twenty-nine patients (27 males, two females) with acute MI who enrolled in the 4-week hospitalized phase II rehabilitation program were assessed. All patients enrolled in this study had received coronary interventions. The rehabilitation consisted of exercise training, education and counseling. We evaluated the physical and psychological status of the patients before and just after the program, and at a 6-month follow up. The physical status was assessed by exercise tolerance measured by the peak oxygen consumption and anaerobic threshold, frequency of exercise, and serum concentrations of triglyceride, total cholesterol, high-density lipoprotein-cholesterol, and low-density lipoprotein-cholesterol. The psychological status was assessed by the Spielberger state-trait anxiety inventory questionnaire (STAI) and the self-rating questionnaire for depression (SRQ-D). Thirty-four patients (27 men, seven women) with MI who did not participate in our rehabilitation program served as a control group. After participation in our rehabilitation program, exercise tolerance and the serum lipid profiles of the patients were improved compared with those before rehabilitation. These parameters had improved significantly 6 months after rehabilitation. The STAI anxiety score was improved significantly and the SRQ-D depression score tended to be improved just after the rehabilitation program. Regular physical activity was continued even 6 months after the completion of the program. Our hospitalized phase II cardiac rehabilitation program improved the management of cardiac risk factors and the psychological status in patients with MI. This comprehensive program may contribute to the secondary prevention of MI as well as the recovery of physical and psychological activities.     

程序康复对急性心肌梗死患者生活质量的影响

目的 :观察 2周程序康复能否改善急性心梗 (AMI)患者的生活质量 (QOL)。方法 :通过多种QOL问卷(QOLQ)对顺利完成早期康复计划的 2 1例AMI患者进行QOL评估。结果 :对完成程序康复的AMI患者 (平均住院时间为 15 .4 1± 3 .76天 )通过WHOQOL等量表进行QOLQ的测试 ,主观感受积分较对照组高 (P <0 .0 0 1) ,在生理、心理及环境领域的得分亦高于对照组 (P <0 .0 0 0 1)。结论 :AMI患者早期程序康复可改善患者的生活质量     

早期心脏康复程序对急性心肌梗死患者经皮冠状动脉介入术后心脏收缩功能的影响

目的:通过三维斑点追踪成像技术评估急性心肌梗死患者(AMI)经皮冠状动脉介入术(PCI)后的左室整体及局部收缩功能变化,探讨以社区为主的早期心脏康复训练对AMI患者的心功能影响。方法:根据是否愿意参加心脏康复,将急性心肌梗死术后患者分为康复组(25例)和对照组(25例)。其中,康复组参与12周的心脏康复程序,进行早期心脏康复训练。对照组仅接受常规护理。在研究开始前、结束后,所有患者均接受三维斑点追踪成像(Three-dimensional speckle tracking imaging,3D-STI)检查,获得左心室整体及各节段纵向、径向、周向及面积应变值(LS、RS、CS、AS)。结果:经过12周的康复程序后,康复组的整体纵向应变(global longitudinal strain,GLS)、整体圆周应变(global circumferential strain,GCS)、整体径向应变(global radial strain,GRS)、整体面积应变(global area strain,GAS)及左室射血分数(left ventricular ejection fraction,LVEF)较对照组显著增加(P0.01)。根据左室心肌节段分区法,两组间左前降支供血区域各有150节段,左回旋支供血区域各有125节段,右冠脉供血区域各有125节段。经过12周的康复程序后,康复组不同冠脉供血区域的LS、RS、CS、AS较对照组显著增加(P0.05)。结论:早期心脏康复治疗可以改善经PCI术后患者的心脏收缩功能。     

早期康复治疗对急性心肌梗死患者生活质量的影响(英文)

目的现代康复的目的在于改善患者的生活质量,以运动为基础的心脏康复可以改善急性心肌梗死(AMI)患者的运动耐量,观察两周程序康复能否改善AMI患者的生活质量(QOL)。方法通过多种QOL问卷(QOLQ)对顺利完成早期康复计划的21例AMI患者进行QOL评估。结果对完成程序康复的AMI患者(平均住院时间为(15±4)d,通过中文版WHOQOL等量表进行QOLQ的测试,主观感受积分较对照组高(P<0.001),在生理、心理及环境领域的得分亦高于对照组(P均<0.0001)。但在社会关系领域则无统计学上的差异;生活质量指数量表则两组之间无显著差异。结论AMI患者早期程序康复可改善患者的生活质量。     

A randomized controlled trial of the effect of psychotherapy on anxiety and depression in chronic obstructive pulmonary disease

OBJECTIVE: To assess the effect of psychotherapy on the anxiety and depression levels of patients with chronic obstructive pulmonary disease (COPD). DESIGN: A blind, randomized, controlled trial. SETTING: Outpatient university pulmonary rehabilitation program in Brazil. PARTICIPANTS: Thirty patients with COPD (mean age, 60.33y; 22 men) attending a pulmonary rehabilitation program were randomized into 2 groups: experimental group (G1) and control group (G2). Both groups underwent a 12-week treatment program. INTERVENTIONS: Group 1 (n=14) participated in 24 sessions of physical exercise, 24 sessions of physiotherapy, 12 psychologic sessions, and 3 educational sessions. Group 2 did not participate in psychotherapy sessions. MAIN OUTCOME MEASURES: All patients were evaluated at baseline and at completion of the pulmonary rehabilitation program by using 3 instruments: the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and 6-minute walk distance (6MWD). RESULTS: Both groups showed statistically significant improvements on the 6MWD (G1, P<.001; G2, P=.03). Only G1 had a significant reduction in anxiety and depression levels (G1: BAI, P<.001; BDI, P<.001; G2: BAI, P=.156; BDI, P=.142). Statistically significant differences existed between G1 and G2 for BAI (P<.001) and BDI (P=.02). CONCLUSIONS: Including psychotherapy in a pulmonary rehabilitation program for COPD reduced patients' anxiety and depression levels but did not modify 6MWD performance.     

早期康复护理对急性心肌梗死患者生活质量的影响

目的 探讨早期康复护理对急性心肌梗死患者生活质量的影响.方法 将210例急性心肌梗死患者随机分为康复组(105例)和对照组(105例).康复组患者实施2 w康复程序,然后应用中文版SF-36健康调查量表测评患者的生活质量;对照组采用传统方法.并随访2年.比较两组生活质量的改善情况.结果 康复组生活质量改善明显,与对照组比较6个维度差异有显著性意义(P＜0.05或P＜0.01);1个月后康复组各维度得分接近正常人的生活质量,而对照组改变不明显;两组的平均住院日数比较有显著差异(P＜0.01);两组在恢复工作、家务活动、性生活恢复、体育锻炼等项目的 比较差异有显著性意义(P＜0.05或P＜0.01).结论 早期康复护理有助于提高急性心肌梗死患者的生活质量.     

A short course of cardiac rehabilitation program is highly cost effective in improving long-term quality of life in patients with recent myocardial infarction or percutaneous coronary intervention

OBJECTIVE: To evaluate the long-term effect of a cardiac rehabilitation and prevention program (CRPP) on quality of life (QOL) and its cost effectiveness. DESIGN: Prospective, randomized controlled trial. SETTING: University-affiliated outpatient cardiac rehabilitation and prevention center. PARTICIPANTS: A total of 269 patients (76% men; mean age, 64+/-11 y) with recent acute myocardial infarction (AMI; n=193) or after elective percutaneous coronary intervention (PCI; n=76) were randomized in a ratio of 2 to 1. INTERVENTION: Patients received either CRPP (an 8-wk exercise and education class in phase 2) or conventional therapy without exercise program (control group). They were followed until they had completed all 4 phases of the program (ie, 2 y). MAIN OUTCOME MEASURES: QOL assessments, by using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and Symptoms Questionnaire, were performed at the end of each phase. Direct health care cost was calculated, whereas cost utility was estimated as money spent (in US dollars) per quality-adjusted life-year (QALY) gained. RESULTS: In the CRPP group, 6 of the 8 SF-36 dimensions improved significantly by phase 2 and were maintained throughout the study period. Patients were less anxious and depressed, and felt more relaxed and contented. In the control group, none of the SF-36 dimensions were improved by phase 2, and bodily pain was increased. In phase 4, only 4 dimensions were improved. Symptoms were unchanged except for increased hostility score. There was a significant gain in net time trade-off in the CRPP group after phase 2. The direct health care expenses in the CRPP and control groups were 15,292 dollars and 15,707 dollars per patient, respectively. Therefore, the cost utility calculated was 640 dollars saved per QALY gained. Savings attributable to CRPP were primarily explained by the lower rate (13% vs 26% of patients, chi2 test=3.9, P <.05) and cost of subsequent PCI (P =.01). CONCLUSIONS: In an era of managing patients with coronary heart disease, a short-course CRPP was highly cost effective in providing better QOL to patients with recent AMI or after elective PCI. In addition, the improvement of QOL was quick and sustained for at least 2 years after CRPP.