基于心肺运动试验的医护人员健康状况研究
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摘要
目的基于心肺运动试验(CEPT),探讨及研究当今医疗强度下医护人员的心肺运动功能变化情况,为不同的医护人员制订合理的运动处方提供依据。方法收集2017年11月～2018年6月广东省中医院大学城医院59名医护人员,根据运动时间不同分为运动组30名与不运动组29名,分别对两组进行CEPT并监测心电图、血压、最大氧耗量(VO_(2max))、无氧阈(AT)、最大分钟通气量(VE_(max))、最大心率(HR_(max))、氧脉搏(O_(2pulse))等。运动过程中两组气促症状按Borg主观感觉疲劳程度评定表(RPE)分级。结果运动组AT低于不运动组,VO_(2max)、VE_(max)、HR_(max)、O_(2pulse)均高于不运动组,差异均有统计学意义(P <0.05或P <0.01);两组RPE分级均集中表现为很吃力(17～18分),差异无统计学意义(P> 0.05)。结论运动组医护人员的平均心肺功能水平明显高于不运动组医护人员,CEPT的结果为医护人员运动处方的制订提供了科学依据,有利于制订个体化的运动锻炼项目,提高健康水平,为医护人员应对抢救、手术以及值班等各种临床工作提供保障。
Objective Based on cardiopulmonary exercise tests(CEPT), to explore and study the changes of cardiopulmonary exercise function of medical staff under current medical intensity, to provide reference for different medical staff to develop a reasonable exercise prescription. Methods From November 2017 to June 2018, 59 medical staff from University Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine were selected and they were divided into exercise group 30 cases and non-exercise group 29 cases according to different exercise time. CEPT was performed in the two groups. The electrocardiogram, blood pressure, maximum oxygen consumption(VO_(2 max)), anaerobic threshold(AT), maximum minute ventilation(VE_(max)), maximum heart rate(HR_(max)), and oxygen pulse(O_(2 pulse)) were monitored in the two groups. The symptoms of shortness of breath during exercise are graded according to the Borg subjective feeling fatigue rating scale(RPE) in the two groups. Results AT in the exercise group was lower than that in the non-exercise group, while VO_(2 max), VE_(max), HR_(max), O_(2 pulse) were higher in the exercise group, and the differences were all statistically significant(P < 0.05 or P < 0.01). RPE grading in the two groups concentrated in difficulty(17-18 points),and the differences had no statistically significant(P > 0.05). Conclusion The average cardiopulmonary function level of the medical staff in the exercise group is significantly higher than that in the non-exercise group. The results of CEPT provide a scientific basis for the exercise prescriptions for medical staff, which is conducive to the development of individualized exercise programs and improvement of health level, and provides protection for various clinical tasks such as rescue, surgery and duty.
Objective Based on cardiopulmonary exercise tests(CEPT), to explore and study the changes of cardiopulmonary exercise function of medical staff under current medical intensity, to provide reference for different medical staff to develop a reasonable exercise prescription. Methods From November 2017 to June 2018, 59 medical staff from University Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine were selected and they were divided into exercise group 30 cases and non-exercise group 29 cases according to different exercise time. CEPT was performed in the two groups. The electrocardiogram, blood pressure, maximum oxygen consumption(VO_(2 max)), anaerobic threshold(AT), maximum minute ventilation(VE_(max)), maximum heart rate(HR_(max)), and oxygen pulse(O_(2 pulse)) were monitored in the two groups. The symptoms of shortness of breath during exercise are graded according to the Borg subjective feeling fatigue rating scale(RPE) in the two groups. Results AT in the exercise group was lower than that in the non-exercise group, while VO_(2 max), VE_(max), HR_(max), O_(2 pulse) were higher in the exercise group, and the differences were all statistically significant(P < 0.05 or P < 0.01). RPE grading in the two groups concentrated in difficulty(17-18 points),and the differences had no statistically significant(P > 0.05). Conclusion The average cardiopulmonary function level of the medical staff in the exercise group is significantly higher than that in the non-exercise group. The results of CEPT provide a scientific basis for the exercise prescriptions for medical staff, which is conducive to the development of individualized exercise programs and improvement of health level, and provides protection for various clinical tasks such as rescue, surgery and duty.
引文
[1]宁亮,孙兴国.心肺运动试验在临床医学领域的临床应用[J].中国全科医学,2013,16(11):3898-3902.
[2]代薇,杨祖福.心肺运动试验与冠心病康复[J].中国康复理论与实践,2010,16(10):947-949.
[3]罗陵.主观感觉疲劳程度(RPE)与递增负荷跑台试验通气阈的关系[J].四川体育科学,1988(3):37-41.
[4]黄思贤,谭新洪.心肺运动试验的临床应用[M].北京:人民卫生出版社,2007:111-155.
[5]徐莉,徐治群,徐双华.湖北省综合性医院医务人员身心健康状况影响因素研究[J].中国社会医学杂志,2013,30(2):104-106.
[6] Herdy AH,Ritt LE,Stein R,et al. Cardiopulmonary Exercise Test:Background,Applicability and Interpretation[J].Arq Bras Cardiol,2016,107(5):467-481.
[7]王浩彦.心肺运动试验指导肺康复运动处方的设计[J].心肺血管病杂志,2016,35(2):141-142.
[8]冯栋宏,何栩,虞亚明.阳虚体质运动员运动心肺功能试验临床观察[J].中医药临床杂志,2016,28(3):387-389.
[9]朱利月,任爱华,寿晓玲.CPET评估制定运动处方指导下的有氧运动对COPD患者心肺功能的影响[J].心脑血管病防治,2017,17(6):470-472.
[10]王钟音.北京市不同等级医院医务人员工作者体育锻炼现状及运动投入情况调查研究[J].继续医学教育,2015,29(2):81-82.
[11]赵东生.提高医护人员心脏功能运动处方研究[J].继续医学教育,2016,30(1):96-97.
[12]赵桂华,徐金义.心肺运动试验在呼吸系统中的应用[J].实用诊断与治疗杂志,2003,17(4):270-272.
[13]苏远力.健康年轻人功率自行车与平板运动心肺功能试验比较研究[D].广州:广州医科大学,2009.
[14]邹常奇.某三级甲等医院医护人员健康状况调查与分析[D].大连:大连医科大学,2014.
[15]中国老年保健医学研究会老龄健康服务与标准化分会.中国社区心肺康复治疗技术专家共识[J].中国老年保健医学,2018,16(3):41-56.
[16]郝璐,孙兴国,谢友红.新理论体系指导心肺运动试验的正确判读与临床应用[J].中国老年保健医学,2018,16(4):68-69.
[17]夏蕊,孙兴国,黄燕.心肺运动试验中通气效率在心肺疾病中的应用[J].中国老年保健医学,2018,16(4):70-73.
[18]林敏,刘耿星,林艺嫔,等.办公室青年人群心肺功能状态及其影响因素研究[J].中国全科医学,2018,21(13):1568-1572.
[19]车琳.心肺运功试验:原理及常用指标[J].临床心电学杂志,2017,26(4):243-247.
[20]郭辉,孙景权,张一民.74例健康青年志愿者心肺运动试验、六分钟上下楼梯试验结果对比观察[J].山东医药,2016,56(23):52-54.
[2]代薇,杨祖福.心肺运动试验与冠心病康复[J].中国康复理论与实践,2010,16(10):947-949.
[3]罗陵.主观感觉疲劳程度(RPE)与递增负荷跑台试验通气阈的关系[J].四川体育科学,1988(3):37-41.
[4]黄思贤,谭新洪.心肺运动试验的临床应用[M].北京:人民卫生出版社,2007:111-155.
[5]徐莉,徐治群,徐双华.湖北省综合性医院医务人员身心健康状况影响因素研究[J].中国社会医学杂志,2013,30(2):104-106.
[6] Herdy AH,Ritt LE,Stein R,et al. Cardiopulmonary Exercise Test:Background,Applicability and Interpretation[J].Arq Bras Cardiol,2016,107(5):467-481.
[7]王浩彦.心肺运动试验指导肺康复运动处方的设计[J].心肺血管病杂志,2016,35(2):141-142.
[8]冯栋宏,何栩,虞亚明.阳虚体质运动员运动心肺功能试验临床观察[J].中医药临床杂志,2016,28(3):387-389.
[9]朱利月,任爱华,寿晓玲.CPET评估制定运动处方指导下的有氧运动对COPD患者心肺功能的影响[J].心脑血管病防治,2017,17(6):470-472.
[10]王钟音.北京市不同等级医院医务人员工作者体育锻炼现状及运动投入情况调查研究[J].继续医学教育,2015,29(2):81-82.
[11]赵东生.提高医护人员心脏功能运动处方研究[J].继续医学教育,2016,30(1):96-97.
[12]赵桂华,徐金义.心肺运动试验在呼吸系统中的应用[J].实用诊断与治疗杂志,2003,17(4):270-272.
[13]苏远力.健康年轻人功率自行车与平板运动心肺功能试验比较研究[D].广州:广州医科大学,2009.
[14]邹常奇.某三级甲等医院医护人员健康状况调查与分析[D].大连:大连医科大学,2014.
[15]中国老年保健医学研究会老龄健康服务与标准化分会.中国社区心肺康复治疗技术专家共识[J].中国老年保健医学,2018,16(3):41-56.
[16]郝璐,孙兴国,谢友红.新理论体系指导心肺运动试验的正确判读与临床应用[J].中国老年保健医学,2018,16(4):68-69.
[17]夏蕊,孙兴国,黄燕.心肺运动试验中通气效率在心肺疾病中的应用[J].中国老年保健医学,2018,16(4):70-73.
[18]林敏,刘耿星,林艺嫔,等.办公室青年人群心肺功能状态及其影响因素研究[J].中国全科医学,2018,21(13):1568-1572.
[19]车琳.心肺运功试验:原理及常用指标[J].临床心电学杂志,2017,26(4):243-247.
[20]郭辉,孙景权,张一民.74例健康青年志愿者心肺运动试验、六分钟上下楼梯试验结果对比观察[J].山东医药,2016,56(23):52-54.