專題討論7:心臟復健
Cardiac Rehabilitation

程 序 表

S7-2
冠狀動脈繞道手術後的心臟復健
Cardiac Rehabilitation for Patients after Coronary Artery Bypass Grafting Surgery
藍青 (Ching Lan)
臺大醫院 復健部

  Patients recovering from coronary artery bypass grafting (CABG) surgery are recommended to receive cardiac rehabilitation (CR) services. The substantial benefits of CR include exercise capacity enhancement, amelioration of cardiovascular risk factors, improvement of psychological well-being, and reduction of mortality. Previous studies reported that exercise training for patients with CABG might increase peak oxygen uptake ( O2peak), muscular strength, cardiac output and stroke volume, ventricular efficiency and quality of life. Short-term exercise training also reduced blood pressure, blood sugar, low density lipoprotein cholesterol and inflammatory marker. Additionally, exercise training may improve graft patency, and reduce cardiac events and readmission rate.

  Exercise training induces a significant improvement of physical capacity in patients with CABG. Previous studies reported 10.5-48.2% increase in O2peak after 2 weeks to 6 months of training in outpatient cardiac rehabilitation, depended on different exercise protocol and the initial level of fitness.

  For most of the developing countries, nonequipment-based CR programs are the most practical option, and the type of program should be matched to the needs and resources of each community. Tai Chi Chuan (TCC) is a popular conditioning exercise in the Chinese community, and previous studies have proved its beneficial effects to patients with CABG and cardiovascular risk factors.

  In conclusion, short-term exercise training for patients with CABG showed benefits to cardiorespiratory function, muscular strength, metabolic profile, endothelial function, and quality of life. Thus, exercise training is beneficial to patients with CABG and it should be recommended to most of the patients to improve their cardiovascular health and reduce cardiac events.