Niset G, Coustry-Degré C, Degré S
Centre de Réadaptation Cardiaque et Service de Cardiologie, Hôpital Erasme, Université Libre de Bruxelles, Belgique.
Cardiology. 1988;75(4):311-7. doi: 10.1159/000174391.
Experience on the rehabilitation of 62 heart-transplanted patients with a mean follow-up period of 15 months and a total survival rate of 79% is reported. From the present study we may conclude that: (a) One month after surgery, oxygen consumption of transplanted patients compared to coronary artery bypass-grafted patients was statistically lower (p less than 0.025). An excess ventilation was observed in transplanted patients in relation mainly to an excessive increase in blood lactates. (b) Improvement of maximal working capacity observed immediately after grafting was still enhanced after 1 year of a comprehensive rehabilitation program (p less than 0.001). This improvement was more related with an improvement of the respiratory function and of the peripheral factors than with a circulatory effect. (c) Four months after transplantation 71% of the patients still at work 6 months before operation returned to work. (d) The quality of life, well-being and heart acceptation demonstrated an immediate increase in physical items after transplantation while psychosocial items decreased postoperatively and normalized after weeks or months.
报告了62例心脏移植患者的康复经验,平均随访期为15个月,总生存率为79%。从本研究中我们可以得出以下结论:(a) 术后1个月,与冠状动脉搭桥移植患者相比,移植患者的耗氧量在统计学上较低(p<0.025)。观察到移植患者存在过度通气,主要与血乳酸过度增加有关。(b) 移植后立即观察到的最大工作能力的改善在综合康复计划实施1年后仍有所增强(p<0.001)。这种改善更多地与呼吸功能和外周因素的改善有关,而非循环效应。(c) 移植后4个月,术前6个月仍在工作的患者中有71%恢复了工作。(d) 生活质量、幸福感和心脏接受度显示,移植后身体方面的指标立即增加,而心理社会方面的指标术后下降,并在数周或数月后恢复正常。