盧冬雪 何琦

摘 要 目的：探討增強(qiáng)型體外反搏（EECP）治療冠心病伴心功能不全的效果。方法：選取82例冠心病伴心功能不全患者，采用隨機(jī)數(shù)字表法將其分為對(duì)照組和觀(guān)察組各41例，對(duì)照組采用心臟康復(fù)訓(xùn)練，觀(guān)察組采用心臟康復(fù)訓(xùn)練結(jié)合EECP治療，比較兩組患者的心功能指標(biāo)、運(yùn)動(dòng)耐量和療效。結(jié)果：治療后觀(guān)察組總有效率高于對(duì)照組；左心室射血分?jǐn)?shù)（LVEF）高于對(duì)照組，左室收縮末內(nèi)徑（LVESD）、左室舒張末內(nèi)徑低于對(duì)照組；達(dá)到運(yùn)動(dòng)終點(diǎn)時(shí)間、6 min內(nèi)最大步行距離高于對(duì)照組（P<0.05）。結(jié)論：心臟康復(fù)訓(xùn)練結(jié)合EECP治療冠心病伴心功能不全能夠有效改善患者的心功能，提高運(yùn)動(dòng)耐量和療效。

關(guān)鍵詞 心臟康復(fù)訓(xùn)練 增強(qiáng)型體外反搏 冠心病 心功能不全 運(yùn)動(dòng)耐量

中圖分類(lèi)號(hào)：R493； R541.4 文獻(xiàn)標(biāo)志碼：B 文章編號(hào)：1006-1533（2021）19-0024-03

Effect of EECP in the treatment of coronary heart disease with cardiac insufficiency

LU Dongxue1， HE Qi2

（1. Second Department of Cardiology； 2. Department of Emergency， Jiamusi Central Hospital， Jiamusi 154002， China）

ABSTRACT Objective： To investigate the effect of the enhanced external counterpulsation （EECP） in the treatment of coronary heart disease with cardiac insufficiency. Methods： Eighty-two cases of the patients were selected and divided into a control group and an observation group with 41 cases each based on a random number table method. The control group underwent cardiac rehabilitation training while the observation group received cardiac rehabilitation training combined with EECP therapy. The indexes of cardiac function， the exercise tolerance and the curative effect were compared between the two groups. Results： After treatment， the total effective rate and the left ventricular ejection fraction （LVEF） were higher， the left ventricular endsystolic diameter （LVESD） and the left ventricular end-diastolic diameter were smaller and the time for reaching the end point and the maximum walking distance within 6 min were longer in the observation group than the control group （P<0.05）. Conclusion： Cardiac rehabilitation training combined with EECP for the treatment of coronary heart disease with cardiac dysfunction can effectively improve the cardiac function and the exercise tolerance of patients and enhance the efficacy.

KEy wORDS cardiac rehabilitation training； enhanced external counterpulsation； coronary heart disease； cardiac insufficiency； exercise tolerance

目前主要采用利尿、調(diào)脂、抗血小板聚集、硝酸酯類(lèi)藥物、β-受體阻滯劑等藥物治療冠心病[1-2]。相關(guān)報(bào)道顯示，治療期間進(jìn)行心臟康復(fù)訓(xùn)練對(duì)改善預(yù)后有著積極的影響[3]。隨著醫(yī)學(xué)技術(shù)的不斷發(fā)展，增強(qiáng)型體外反搏（enhanced external counterpulsation，EECP）作為一種無(wú)創(chuàng)、安全的機(jī)械循環(huán)輔助治療技術(shù)，可有效增加機(jī)體心肌灌注，改善血管內(nèi)皮功能，促進(jìn)側(cè)支循環(huán)建立，有益于冠心病病情的改善[4]。

1 資料與方法

1.1 一般資料

選取2017年3月—2019年3月佳木斯市中心醫(yī)院收治的冠心病伴心功能不全患者82例，采用隨機(jī)數(shù)字表法將其分為觀(guān)察組和對(duì)照組各41例。其中觀(guān)察組男23例，女18例；年齡31～75歲，平均年齡（62.49±6.62）歲；病程1～17年，平均病程（4.25±1.36）年。對(duì)照組男25例，女16例；年齡28～78歲，平均年齡（62.38±6.41）歲；病程1～16年，平均病程（4.38±1.17）年。兩組患者一般資料比較差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05），具可比性。