Renshaw D C, Karstaedt A
Department of Psychiatry, Loyola University Stritch School of Medicine, Maywood, IL 60153.
Compr Ther. 1988 Apr;14(4):61-6.
The heart has been regarded throughout history as the central core of life and emotions, of kindness and generosity, courage and grief. Cardiac disease can be overwhelming for both the patient and for the partner, and fear of death is a common and quite normal response. Sexual activity after convalescence is a valuable incentive for patients to undergo rehabilitation. Self-confidence and satisfaction can be greatly enhanced by affectionate closeness, and prolonged foreplay can be savored at any age. Sex play is relaxing and healthful whereas anxious sexual preoccupation, frustration, and avoidance may actually be greater risk factors than the mild physical effort involved for coitus or coital alternatives. Male and female patients with cardiac disease expressed regret that their primary physician, cardiologist, or surgeon had not broached the subject of sexual function before or after the acute illness. They were interested, but both patients and physicians were probably uncomfortable with explicit sexual dialogue. Some common sense reminders to post-MI and post-CABS patients about sexual function may be given verbally or in written form, together with diet and exercise instructions. These should include: a heavy meal or heavy alcohol intake before coitus should be avoided; early morning can be an ideal time for coitus or sex play; moderate room temperature is best; a comfortable sexual position can be found with experimentation; chest pain or palpitations are signals to use appropriate medications; and coital death is rare in a stable, long-standing sexual relationship.(ABSTRACT TRUNCATED AT 250 WORDS)
心脏在历史上一直被视为生命与情感、善良与慷慨、勇气与悲伤的核心。心脏病对患者及其伴侣来说都可能是难以承受的,对死亡的恐惧是一种常见且完全正常的反应。康复后的性活动是激励患者进行康复治疗的重要因素。深情的亲密接触能极大增强自信与满足感,任何年龄都能尽情享受延长的前戏。性游戏轻松有益,而焦虑的性关注、挫折感和回避行为实际上可能比性交或替代性交方式中涉及的轻微体力消耗带来更大的风险因素。患有心脏病的男性和女性患者表示遗憾的是,他们的初级保健医生、心脏病专家或外科医生在急性病发作之前或之后都没有提及性功能的话题。他们对此感兴趣,但患者和医生可能都对明确的性对话感到不自在。对于心肌梗死后和冠状动脉搭桥术后的患者,可以口头或书面形式给出一些关于性功能的常识性提醒,同时附上饮食和运动指导。这些提醒应包括:性交前应避免大餐或大量饮酒;清晨可能是性交或性游戏的理想时间;适中的室温最佳;通过尝试可以找到舒适的性交姿势;胸痛或心悸是使用适当药物的信号;在稳定、长期的性关系中,性交时死亡的情况很少见。(摘要截选至250字)