Атеросклероз (Dec 2014)
Secondary prevention and rehabilitation of patients with the myocardial infarction in policlinic
Abstract
Research objective. Increase of efficiency of secondary prevention of a myocardial infarction and rehabilitation of patients at an out-patient stage. Materials and methods. 164 patients of both floors with the transferred myocardial infarction with enzymatic and endovascular restoration of a blood-groove of an ischemic myocardium are surveyed. The diagnosis of a myocardial infarction is established according to standards of diagnostics of ESC/ACCF/AHA (2007) also it is documented by an extract from the clinical record of office of medical institution where hospital treatment of the patient according to emergency indications was carried out. Patients were divided into 3 groups: the 1st (supervision with rehabilitation in out-patient conditions), the 2nd (rehabilitations in the round-the-clock specialized office), the 3rd (comparisons). To all patients continuous reception of pharmacological therapy according to standards of treatment of patients with the sharp coronary syndrome (SCS) was appointed; recommendations of the general character about healthy lifestyle observance are made; laboratory blood tests, electrocardiography and heart echocardiography, holterovsky (daily) monitoring of the electrocardiogram, assessment of degree of heart failure on the scale of an assessment of a clinical state (SACS) and the test of 6 minute walking, a commitment assessment to treatment with use of test of Moriski-Green, an assessment of quality of life of patients with heart failure on the Minnesota questionnaire, an assessment of episodes of repeated hospitalization concerning Construction Department and lethal outcomes are carried out. In addition to the 1st group of patients “Health school” and LFK, the 2nd group - a rehabilitation course in specialized office of recovery treatment of GBUZ NSO GKB №19 were on an outpatient basis carried out. Results. On achievement of commitment to treatment, estimates of an average value of quality of life, episodes of repeated Construction Departments, to reduction of weight of a functional class of heart failure indicators of patients of the 1st group surpassed data on patients of the 3rd group, but conceded to the 2nd. Conclusion. Use of rehabilitation actions at an out-patient and polyclinic stage of treatment of patients with transferred IT as element of secondary prevention of cardiovascular complications positively influence final points irrespective of a method of a revascularization of a myocardium.
