1例冠状动脉旁路移植术合并下肢动脉硬化闭塞症患者的心脏康复体会

Cardiac rehabilitation in a case of CABG with arterio sclerosis obliterans

冠状动脉旁路移植术后和周围动脉粥样硬化性疾病患者运动康复的效果已分别得到证实,并得到各自疾病相关指南的推荐。两者同时存在时,患者的运动评估方法和运动康复方案有其特殊性。我中心对1例冠状动脉旁路移植合并下肢动脉硬化闭塞症患者实施了1个月系统化心脏康复治疗后,患者的峰值摄氧量、最大代谢当量、无氧阈功率、6 min步行距离、出现跛行的距离均有提高;血压及血糖等危险因素控制在目标范围。患者的心肺功能、身体活动能力得到了提高,下肢疼痛和跛行症状有所缓解;疾病的危险因素得到了控制。通过本例患者的心脏康复治疗,对冠状动脉旁路移植术后合并周围动脉粥样硬化性疾病患者的运动康复和二级预防有了更进一步的思考。

The effects of exercise rehabilitation on patients with coronary artery bypass grafting(CABG)and peripheral artery disease(PAD)have been confirmed and the exercise rehabilitations have been recommended by their respective disease guidelines.When both CABG and PAD are present in a same patient,the exercise evaluation method and exercise rehabilitation program of patients have their special characteristics.After a onemonth systematic cardiac rehabilitation treatment in a patient with CABG combined with lower limb arteriosclerosis occlusitis,the patient's peak oxygen intake,maximum metaprometric value,power at anaerobic threshold,6-minute walking distance and distance of clavitation were all improved.Risk factors such as blood pressure and blood sugar were controlled within the target range.The patient's cardiopulmonary function and physical activity ability were improved and the lower limb pain and claudication symptoms were relieved.The risk factors for the disease are under control.Through the cardiac rehabilitation treatment of this patient,we have further thought about the exercise rehabilitation and secondary prevention of patients with PAD after CABG.