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专家提醒:冠心病患者术后心脏康复不容忽视

2019-02-18 18:03:01    新华网

新华社天津2月18日电(记者毛振华)冠心病患者做了支架或搭桥术后,是否就能高枕无忧?天津泰达国际心血管病医院心脏康复科主任郭琪日前表示,这是一种认识误区,后期心脏康复仍需跟上,才能降低术后复发、卒中及再住院风险。

“不管哪种治疗方法,只是让血管‘临时畅通’,并没有从根本上解除造成血管‘拥堵’的因素。”郭琪说,冠心病患者在接受了支架植入术或搭桥术后,不再心绞痛或胸闷、憋气,但这并不意味着毫无风险。

郭琪说,冠心病常见的危险因素有高血压、糖尿病、血脂异常、吸烟、肥胖等,“如果这些危险因素一直存在,已经通畅的血管或其他正常的血管都可能还会再次出现狭窄,甚至阻塞、突发急性缺血事件。”

全球急性冠状动脉事件注册研究表明,即使经过手术治疗和药物治疗,冠心病患者出院后6个月内死亡、卒中和再住院率仍高达25%,4年累计病死率高达22.6%,而且死亡患者中50%死于再发心肌梗死。

在冠心病患者术后康复上,实施系统的心脏康复对维持血管通畅,提高生活质量,减少猝死率、再发病率和再入院率有很大帮助。大量国内外研究也表明,术后恢复期的心脏康复可以使发病三年后的死亡率减少45%到83%。

郭琪介绍,心脏康复是通过多种手段联合干预,为心血管疾病患者在急性期、恢复期、维持期以及整个生命过程中提供生理、心理和社会的全面、全程管理服务与关爱。

发病后的4天到7天内为急性期,以生命安全和回归正常日常生活为目标;1周到6个月为恢复期,以复职和回归社会为目标;6个月之后以健康生活习惯养成、危险因素控制和健康管理方式构建为目标。

郭琪特别建议,国际流行病学研究和干预性研究表明,药物治疗和非药物治疗结合是最有效的冠心病二级预防策略,而非药物治疗就属于心脏康复内容范围。相关患者要特别注意后期的心脏康复,不可大意,争取早日使身体回归健康状态。

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