这种模式有很多好处。许多突发心脏病的患者因急诊入院时往往是他们第一次入院治疗,他们甚至不知道自己患有心脏疾病。这些患者入院后接受急诊PCI或手术治疗,PCI治疗后当天或数天之后即可出院回家,他们可能并不清楚自己发生了什么,因此复诊时,非常需要专业人士解释在急诊入院的两三天里发生的事情。
International Circulation: Considering Austria has been conducting cardiac rehabilitation for some time, what would you say is the most basic level of rehabilitation that should be initiated?
《国际循环》:奥地利已经进行了一段时间的心脏康复模式计划,您认为应开展计划的最基本康复模式是什么?
Prof Niebauer: If one were to start a cardiac rehabilitation program, for instance in China or in a location where you previously had nothing, I would definitely start out with exercise training. I think that is the most important because it gives back the most quality of life. The most common symptom is dyspnea (shortness of breath) and that is something that can be improved with exercise training. There may be some angina remaining even though they have been revascularized and exercise training can help them experience less pain. In the end, this improves their quality of life plus making them more optimistic. If yesterday you had to take the elevator but a week from now you are able to take the stairs, play with your children or grandchildren again, then that is a huge improvement to quality of life. I would be putting my money on exercise training.
Niebauer:如果进行心脏康复的患者是在中国偏远地区,没有相关的设备,我肯定会建议以运动训练开始。我认为这是最重要的,因为通过运动锻炼能够恢复更加优质的生活。首先,通过运动训练可以改善心脏病患者最常见呼吸困难(气短)症状;其次,在已经接受血运重建的患者中,也可能出现心绞痛的症状,运动训练同样可以帮助他们减少此种痛苦体验;最终,这将提高他们的生活质量,并使他们更加乐观。如果昨天乘坐电梯,但此后的一周改走楼梯,并再次开始和子女、孙子女玩耍,那将是生活质量的一个巨大改善。因此,我会将有限的资金用在运动训练中。
International Circulation: How has the Austrian rehabilitation program changed over the years? You pointed out in your presentation that they have stopped doing so much inpatient rehabilitation and focusing more on outpatient rehabilitation. Why is that change so important?
《国际循环》:近年来,奥地利的康复计划改革是怎样的?您在演示文稿中指出,目前限制了院内康复而更加注重门诊康复,为什么这些改变非常重要?
Prof Niebauer: Actually it is not that there is less in-hospital rehabilitation (they have maintained that at the same level and even expanded on the in-hospital programs), but they have introduced outpatient cardiac rehabilitation on the side. If you look at the patients who would qualify for cardiac rehabilitation, just by the indication, the disease they have, out of all the patients that qualify only 20%-30% do actually go into cardiac rehabilitation. Of those, 90% will go into in-hospital cardiac rehabilitation.
Niebauer:我们并没有限制院内康复比例(院内康复水平一直没有减少,甚至在院内计划中有所扩张),只是目前较多介绍门诊心脏康复。在需要心脏康复的患者中,由于疾病的限制,最终仅有20%-30%的患者进入门诊心脏康复,而90%患者将进入院内心脏康复。