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基于VR技术的I期心脏康复训练对老年冠心病患者经皮冠脉介入术术后恢复的影响

王颖, 杨盛兰, 罗素新, 童话, 方琴, 郭永正^*

重庆医科大学附属第一医院心血管内科，重庆 400016

摘要

本研究旨在明确基于虚拟现实(virtual reality, VR)技术的I期心脏康复(cardiac rehabilitation, CR)训练在老年冠心病(coronary heart disease, CHD)患者经皮冠脉介入术(percutaneous coronary intervention, PCI)术后应用的效果。采用便利抽样法选取重庆医科大学附属第一医院心血管内科2022年6月到2023年4月间接受PCI治疗的老年CHD患者36例，采用随机数字表法将其分为对照组和试验组，每组各18例患者。对照组患者PCI术后接受常规护理干预，试验组患者在此基础上给予基于VR技术的I期CR训练干预。比较两组患者康复前后的6 min步行试验(6 min walk test, 6MWT)距离、简易体能状况量表(Simple Physical Performance Battery, SPPB)、SF-36量表、医院焦虑抑郁量表(Hospital Anxiety and Depression Scale, HADS)和事件影响量表-修订版(Impact of Events Scale-Revised, IES-R)等评分。PCI术后3个月，比较两组患者的主要不良心血管事件(major adverse cardiovascular events, MACE)发生率。结果表明：试验组患者的6MWT距离和SPPB评分均明显高于对照组(P < 0.05)，试验组患者的HADS评分和IES-R评分均明显低于对照组(P < 0.01)，两组患者的SF-36量表评分比较差异无统计学意义(P > 0.05)。PCI术后3个月，两组患者MACE发生率比较差异无统计学意义(P > 0.05)。上述结果提示，基于VR技术的I期CR方案能够改善老年CHD患者PCI术后应激程度和焦虑/抑郁状态，同时增强患者心功能和机体功能状态，且未增加患者不良心脏事件发生风险，是一种安全、可靠的康复方案。

关键词： 虚拟现实技术; I期心脏康复; 老年冠心病患者; 经皮冠脉介入术术后

Effects of virtual reality in phase I cardiac rehabilitation training for elderly coronary heart disease patients after percutaneous coronary intervention

WANG Ying, YANG Sheng-Lan, LUO Su-Xin, TONG Hua, FANG Qin, GUO Yong-Zheng^*

Division of Cardiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China

Abstract

The study aimed to examine the effects of virtual reality (VR) technology-based phase I cardiac rehabilitation (CR) program in elderly coronary heart disease (CHD) patients after percutaneous coronary intervention (PCI). Thirty-six cases of elderly CHD patients who underwent PCI in the First Affiliated Hospital of Chongqing Medical University from June 2022 to April 2023 were recruited by convenience sampling method. The patients were randomly assigned by means of random digital table method to two study groups: control group (n = 18), which received conventional nursing intervention after PCI, and experimental group (n = 18), which received a combined program of conventional nursing intervention together with CR program based on VR technology. The 6 min walk test (6MWT), Simple Physical Performance Battery (SPPB), SF-36 scale, Hospital Anxiety and Depression Scale (HADS) and Impact of Events Scale-Revised (IES-R) were tested before and after rehabilitation. Moreover, the incidence of major adverse cardiovascular events (MACE) was recorded at 3 months after PCI. After VR-based CR, the 6MWT distance and SPPB scores of patients in the experimental group were higher than those in control group (P < 0.05). The HADS scores and IES-R scores of the patients in the experimental group were lower than those in control group (P < 0.01), and the difference in SF-36 scale scores was not statistically significant between two groups (P > 0.05). The incidence of MACE was not significantly different at 3 months after PCI (P > 0.05). These results suggest that VR-based phase I CR program mitigates the degree of PCI postoperative stress, anxiety, and depression in elderly CHD patients, however, enhances the resistance to fatigue and does not increase the risk of adverse cardiac events, suggesting it is a safe intervention.

Key words: virtual reality technology; phase I cardiac rehabilitation; elderly coronary heart disease patients; post-percutaneous coronary intervention

收稿日期：　　录用日期：

通讯作者：郭永正　　E-mail: gyz_cardio@hospital.cqmu.edu.cn

DOI: 10.13294/j.aps.2023.0077

引用本文：

王颖, 杨盛兰, 罗素新, 童话, 方琴, 郭永正. 基于VR技术的I期心脏康复训练对老年冠心病患者经皮冠脉介入术术后恢复的影响[J]. 生理学报 2023; 75 (6): 953-961.

WANG Ying, YANG Sheng-Lan, LUO Su-Xin, TONG Hua, FANG Qin, GUO Yong-Zheng. Effects of virtual reality in phase I cardiac rehabilitation training for elderly coronary heart disease patients after percutaneous coronary intervention. Acta Physiol Sin 2023; 75 (6): 953-961 (in Chinese with English abstract).