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冠状动脉搭桥手术后住院/门诊心脏康复项目的极短期/短期益处。

Very short/short-term benefit of inpatient/outpatient cardiac rehabilitation programs after coronary artery bypass grafting surgery.

作者信息

Spiroski Dejan, Andjić Mojsije, Stojanović Olivera Ilić, Lazović Milica, Dikić Ana Djordjević, Ostojić Miodrag, Beleslin Branko, Kostić Snežana, Zdravković Marija, Lović Dragan

机构信息

Department of Cardiovascular Rehabilitation, Institute for Rehabilitation, Belgrade, Serbia.

Department of Physical Medicine and Rehabilitation, Institute of Rehabilitation, Belgrade, Serbia.

出版信息

Clin Cardiol. 2017 May;40(5):281-286. doi: 10.1002/clc.22656. Epub 2017 Jan 11.

Abstract

BACKGROUND

Exercise-based rehabilitation is an important part of treatment patients following coronary artery bypass graft (CABG) surgery.

HYPOTHESIS

To evaluate effect of very short/short-term exercise training on cardiopulmonary exercise testing (CPET) parameters.

METHODS

We studied 54 consecutive patients with myocardial infarction (MI) treated with CABG surgery referred for rehabilitation. The study population consisted of 50 men and 4 women (age 57.72 ± 7.61 years, left ventricular ejection fraction 55% ± 5.81%), who participated in a 3-week clinical and 6-month outpatient cardiac rehabilitation program. The Inpatient program consisted of cycling 7 times/week and daily walking for 45 minutes. The outpatient program consisted mainly of walking 5 times/week for 45 minutes and cycling 3 times/week. All patients performed symptom-limited CPET on a bicycle ergometer with a ramp protocol of 10 W/minute at the start, for 3 weeks, and for 6 months.

RESULTS

After 3 weeks of an exercise-based cardiac rehabilitation program, exercise tolerance improved as compared to baseline, as well as peak respiratory exchange ratio. Most importantly, peak VO (16.35 ± 3.83 vs 17.88 ± 4.25 mL/kg/min, respectively, P < 0.05), peak VCO (1.48 ± 0.40 vs 1.68 ± 0.43, respectively, P < 0.05), peak ventilatory exchange (44.52 ± 11.32 vs 52.56 ± 12.37 L/min, respectively, P < 0.05), and peak breathing reserve (52.00% ± 13.73% vs 45.75% ± 14.84%, respectively, P < 0.05) were also improved. The same improvement trend continued after 6 months (respectively, P < 0.001 and P < 0.0001). No major adverse cardiac events were noted during the rehabilitation program.

CONCLUSIONS

Very short/short-term exercise training in patients with MI treated with CABG surgery is safe and improves functional capacity.

摘要

背景

基于运动的康复治疗是冠状动脉旁路移植术(CABG)术后患者治疗的重要组成部分。

假设

评估极短期/短期运动训练对心肺运动试验(CPET)参数的影响。

方法

我们研究了54例接受CABG手术治疗并转诊至康复科的心肌梗死(MI)患者。研究人群包括50名男性和4名女性(年龄57.72±7.61岁,左心室射血分数55%±5.81%),他们参加了为期3周的临床康复计划和为期6个月的门诊心脏康复计划。住院康复计划包括每周骑行7次和每天步行45分钟。门诊康复计划主要包括每周步行5次,每次45分钟,每周骑行3次。所有患者在自行车测力计上进行症状限制的CPET,起始坡度为10W/分钟,持续3周和6个月。

结果

经过3周基于运动的心脏康复计划后,与基线相比,运动耐力以及峰值呼吸交换率均有所改善。最重要的是,峰值摄氧量(分别为16.35±3.83与17.88±4.25mL/kg/min,P<0.05)、峰值二氧化碳排出量(分别为1.48±0.40与1.68±0.43,P<0.05)、峰值通气交换量(分别为44.52±11.32与52.56±12.37L/min,P<0.05)以及峰值呼吸储备(分别为52.00%±13.73%与45.75%±14.84%,P<0.05)也均得到改善。6个月后同样的改善趋势仍持续(分别为P<0.001和P<0.0001)。在康复计划期间未观察到重大不良心脏事件。

结论

接受CABG手术治疗的MI患者进行极短期/短期运动训练是安全的,并可改善功能能力。

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