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[老年患者的心脏康复]

[Cardiac rehabilitation in the elderly patient].

作者信息

Boydak Bahar

机构信息

Department of Internal Medicine, Ege University Faculty of Medicine, İzmir, Turkey.

出版信息

Turk Kardiyol Dern Ars. 2017 Sep;45(Suppl 5):117-119. doi: 10.5543/tkda.2017.53988.

Abstract

As it is the case globally, cardiovascular diseases (CVD) make up the most frequent cause of death in Turkey also. Due to this fact, cardiac rehabilitation (CR) has gained a highly important role in the treatment of coronary artery diseases. In Turkey, mortality and morbidity rates among the elderly patients are significantly high. Disability due to coronary artery diseases is more frequent in the elderly compared to young patients. So, it is clear that CR has a considerable importance in this special group of patients. CR program consists the following core components; early initial assessment of the patient, nutritional counseling, management of lipid profiles, education to quit smoking, weight control, treatment and control of diabetes, emotional assessment and support, physical activity referral and exercise training. All cardiac patients, both the inpatient and outpatient groups can be recruited in the CR program. It is recommended to keep the exercise intensity between 40-80% of the patient's capacity. Exercise and aerobic training should be given together and while doing this, co-morbidities and the drugs currently used by the patient should be taken into account. In conclusion, CR is recommended to be started just after the acute phase of the disease has resolved or the patient is dismissed from the intensive care unit. Periodic follow up and 30 minute of aerobic exercise which is preffered and can be easily performed by the patient every two or three times a week will be adequate to keep the capacity regained. Especially for the patients over 75 years of age, CR program should be considered as a long-term condition management.

摘要

与全球情况一样,心血管疾病(CVD)也是土耳其最常见的死因。鉴于此,心脏康复(CR)在冠状动脉疾病的治疗中发挥了极其重要的作用。在土耳其,老年患者的死亡率和发病率显著较高。与年轻患者相比,冠状动脉疾病导致的残疾在老年人中更为常见。因此,很明显CR在这一特殊患者群体中具有相当重要的意义。CR计划包括以下核心组成部分:患者的早期初步评估、营养咨询、血脂管理、戒烟教育、体重控制、糖尿病的治疗和控制、情绪评估和支持、身体活动转诊和运动训练。所有心脏病患者,包括住院患者和门诊患者,都可以纳入CR计划。建议将运动强度保持在患者能力的40%-80%之间。运动和有氧训练应同时进行,在此过程中,应考虑患者的合并症和目前使用的药物。总之,建议在疾病急性期结束后或患者从重症监护病房出院后立即开始CR。定期随访以及患者每周两到三次进行的30分钟有氧运动(这是首选且患者易于进行的)将足以保持恢复的能力。特别是对于75岁以上的患者,CR计划应被视为一种长期的病情管理。

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