Study On The Effect Of Stage Ⅰ Cardiopulmonary Rehabilitation On The Recovery Of Patients After Coronary Artery Bypass Grafting

Objective: To investigate the effects of Phase-one cardiopulmonary rehabilitation on cardiopulmonary function,exercise ability and quality of life in patients with coronary artery bypass grafting(Coronary Artery Bypass Grafting,CABG).and provide theoretical basis for the formation of an effective standard of cardiopulmonary rehabilitation for patients with coronary heart disease in China and to provide a feasible clinical intervention strategy for cardiopulmonary rehabilitation of patients after CABG.Methods: In this study,we enrolled 300 patients undergoing CABG in cardiac surgery of Ruijin Hospital affiliated to Medical College of Shanghai Jiaotong University from1 January 2016 to December 2017.They were randomly divided into rehabilitation group(n = 150)and control group(n = 150).Both groups carried out general routine nursing and treatment according to the routine of cardiac surgery.On the basis of the control group,the rehabilitation group was treated with phase-one cardiopulmonary rehabilitation intervention for 2 weeks(1-14 days after admission)under the supervision of two rehabilitation technicians and responsible nurses.Specifically for cardiopulmonary rehabilitation health education,exercise training,respiratory muscle training and so on at the time of admission.The cardiac function,six-minute walking distance(6 Minute Walking Distance,6MWD),the score of SF-36 health scale,the incidence of postoperative pulmonary complications and the days of hospitalization were compared between the two groups before and after intervention.In order to evaluate the effect and significance of in-hospital cardiopulmonary rehabilitation on promoting the recovery of CABG patients.Results:1.Before rehabilitation,there was no statistical difference in general demographic data(age,sex,smoking or not),New York cardiac function classification,renal function,fasting blood glucose,liver function and other clinical indexes between the two groups(P > 0.05).The baseline characteristics of rehabilitation group and control group are comparable.2.Comparison of cardiopulmonary function and exercise endurance between the two groups: ○1 Cardiac function: before rehabilitation,There was no significant statistical difference in stroke volume(Stroke Volume,SV),left ventricular ejection fraction(Left Ventricular Ejection Fraction,LVEF),left ventricular end-diastolic diameter(Left Ventricular End-Diastolic Volume,LVEDV)and left ventricular end-systolic diameter(Left Ventricular End-Systolic Volume,LVESV)between the two groups(P >0.05).After intervention,SV,LVEF and LVEDV in rehabilitation group were higher than those in control group,and the difference was statistically significant(P < 005);○2 Exercise endurance: before intervention,there was no difference in 6MWD between the two groups(P > 0 05),but after intervention,6MWD in rehabilitation group was longer than that in control group.The difference was statistically significant(P < 0.05);○3 Incidence of respiratory complications: after phase-one cardiopulmonary rehabilitation,the incidence of pulmonary infection and hypoxemia in the rehabilitation group was lower than that in the control group,and the difference was statistically significant(P < 0.05).3.After intervention,the total hospitalization days in the rehabilitation group(14.13±4.72)were significantly shorter than those in the control group(17.33±5.41),and the difference was statistically significant(P < 0.05).The drainage days of thoracic drainage in rehabilitation group(3.11±0.91)were also shorter than those in control group(3.51±1.11),the difference was statistically significant(P<0.01).4.There was no significant difference in the scores of eight dimensions of SF-36 between the two groups at admission(P>0.05),and the quality of life of rehabilitation group and control group are comparable before rehabilitation.After intervention,the scores of physical function(PF)、role emotional(RE)and mental health(MH)in the rehabilitation group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05).Conclusion:1.Phase-one cardiopulmonary rehabilitation can not only improve the cardiac pumping capacity by increasing SV and LVEF after CABG,but also improve exercise endurance.2.Phase-one cardiopulmonary rehabilitation can can reduce the incidence of postoperative pulmonary infection and hypoxemia,shorten the total hospitalization and thoracic drainage days,and promote the recovery of the disease.3.Phase-one cardiopulmonary rehabilitation is helpful to improve the negative emotions such as anxiety and depression,enhance the quality of life of patients,and promote the return of CABG patients to family,work and society more quickly and better.