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[心肌梗死后住院康复措施的价值]

[Value of inpatient rehabilitation measures following myocardial infarct].

作者信息

Mathes P

出版信息

Z Kardiol. 1984 Dec;73(12):740-7.

PMID:6523972
Abstract

The primary goal of rehabilitation is to slow down the progression of coronary heart disease via secondary preventive efforts and to reduce the negative social and psychosomatic sequelae of a myocardial infarction to the unavoidable minimum. Cardiac rehabilitation has developed into an active strategy of secondary prevention, based on sufficient diagnostic evaluation, aiming at the modification of risks factors and including the entire psychosocial field into the long-term therapeutic concept. After myocardial infarction the patient carries, in comparison to the normal population, approximately a tenfold risk to die suddenly or to suffer another myocardial infarction. Following a first infarction, risk factors such as smoking, hypercholesterolemia and hypertension are of increased epidemiologic importance. A lower social class will in itself lead to an increase of the incidence of reinfarction and to a decrease in life expectancy. One of the central goals therefore is to convey the importance of a health-oriented behavior pattern, which is achieved in single and group-therapy sessions as well as with the help of physiotherapy. Controlled physical exercise, however, does not only serve as an educational vehicle, but also has direct effects on cardiovascular physiology, leading to a decrease in heart rate and blood pressure for a given work load and thus to an increase of the angina pectoris threshold. Moreover, controlled physical exercise has a substantial antidepressive effect in the critical phase following acute myocardial infarction, and will lead to increased self-confidence.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

康复的主要目标是通过二级预防措施减缓冠心病的进展,并将心肌梗死不可避免产生的负面社会和身心后遗症降至最低。心脏康复已发展成为一种二级预防的积极策略,基于充分的诊断评估,旨在改变危险因素,并将整个心理社会领域纳入长期治疗理念。与正常人群相比,心肌梗死后患者突然死亡或再次发生心肌梗死的风险大约高出十倍。首次心肌梗死后,吸烟、高胆固醇血症和高血压等危险因素在流行病学上的重要性增加。社会阶层较低本身会导致再梗死发生率增加和预期寿命缩短。因此,核心目标之一是传达健康行为模式的重要性,这在个体和团体治疗课程以及物理治疗的帮助下得以实现。然而,有控制的体育锻炼不仅是一种教育手段,而且对心血管生理有直接影响,在给定工作量下导致心率和血压下降,从而提高心绞痛阈值。此外,有控制的体育锻炼在急性心肌梗死后的关键阶段具有显著的抗抑郁作用,并会增强自信心。(摘要截选至250字)

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