Pashkow F J
Department of Cardiology, Cleveland Clinic Foundation, OH 44195, USA.
Semin Thorac Cardiovasc Surg. 1995 Oct;7(4):240-7.
Cardiac rehabilitation has evolved into a composite therapy of exercise training, psychosocial support, and education with major goals of returning patients to normalcy after an acute coronary event such as myocardial infarction or coronary bypass surgery. This process seems especially important in patients with significant levels of deconditioning before entering therapy. Survival is improved with a decrease in cardiovascular mortality after myocardial infarction of as much as 20% to 30%. Cardiac rehabilitation for the surgical patient today is additionally important with shortening length of stay, and with regard to the prevention of recurrent disease. Modification of risk factors in patients with known coronary disease has especially meaningful implications for the bypass patient. The percentage of patients returning for second, and even third coronary bypass operations continues to increase. Recent studies suggest the possibility of slowing, and in some cases actual arrest or regression of coronary atherosclerosis, in addition to the reduction of subsequent acute coronary events and the need for future revascularization. Other issues of potential importance include quality of life, return to work after bypass surgery, and noncardiac complications of surgery.
心脏康复已发展成为一种综合治疗方法，包括运动训练、心理社会支持和教育，其主要目标是使患者在经历急性冠状动脉事件（如心肌梗死或冠状动脉搭桥手术）后恢复正常。对于在进入治疗前身体状况明显不佳的患者，这一过程似乎尤为重要。心肌梗死后心血管死亡率降低多达20%至30%，生存率得以提高。如今，心脏康复对于外科手术患者来说，在缩短住院时间以及预防疾病复发方面也格外重要。对于已知患有冠状动脉疾病的患者，危险因素的改变对搭桥手术患者尤其具有重要意义。接受二次甚至三次冠状动脉搭桥手术的患者比例持续上升。最近的研究表明，除了减少后续急性冠状动脉事件和未来血管重建的需求外，还可能减缓，在某些情况下甚至实际阻止或逆转冠状动脉粥样硬化。其他潜在重要问题包括生活质量、搭桥手术后重返工作岗位以及手术的非心脏并发症。
