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[运动负荷试验、无创检查及恢复工作支持下的冠心病晚期手术结果评估]

[Evaluation of late surgical results in coronary disease supported by exercise stress test, noninvasive examination and work resumption].

作者信息

Kmieć G, Zwirski W, Moczurad K

出版信息

Kardiol Pol. 1990 Mar;33(3):179-84.

PMID:2082072
Abstract

The aim of the study was to assess effectiveness of surgery in management of coronary artery disease (CAD) during long-term follow-up in bearings of physical efficiency and work resumption. 21 males observed during 3-7 years after coronary artery by-pass grafting (CABG) underwent the study. Patients age ranged from 37 to 60 years (mean 51.7) at the beginning of the follow-up. 10 patients had hypertension and 12 suffered from myocardial infarction before CABG. Number of by-pass grafts ranged from 2 to 4. Postsurgical rehabilitation was performed in the cardiological health resort hospital. Assessment was based on anamnesis and physical, ECG, noninvasive as well as ECG bicycle exercise stress examinations. Long-term follow-up proved significant postoperative increase of exercise tolerance expressed by prolongation of ECG exercise test duration as well as augmentation of maximal load and performed work. Left ventricular contractility improvement measured by LVET/PEP and LVETI parameters was also stated. The best results were observed up to 6 years after surgery in patients with grafted left anterior descending artery. Preoperative myocardial infarction did not effect on longterm results of surgery. 75% of patients resumed a work after myocardial revascularization.

摘要

本研究的目的是在长期随访中,从身体机能和恢复工作的角度评估手术治疗冠状动脉疾病(CAD)的有效性。对21名男性患者进行了研究,这些患者在冠状动脉旁路移植术(CABG)后3至7年接受观察。随访开始时患者年龄在37岁至60岁之间(平均51.7岁)。10例患者在CABG术前患有高血压,12例曾患心肌梗死。旁路移植血管数量在2至4根之间。术后康复在心脏病疗养院进行。评估基于病史、体格检查、心电图、无创检查以及心电图踏车运动负荷试验。长期随访证明,术后运动耐量显著提高,表现为心电图运动试验持续时间延长、最大负荷增加以及完成的工作量增加。通过LVET/PEP和LVETI参数测量的左心室收缩力也有所改善。在移植了左前降支动脉的患者中,术后6年内观察到了最佳效果。术前心肌梗死对手术的长期效果没有影响。75%的患者在心肌血运重建后恢复了工作。

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