使用左心室輔助器患者之心肺復健：病例報告

對於等待心臟移植而接受人工心臟置入患者，常須長時間等待合適的心臟捐贈者。對於這些患者，我們應強調心肺復健之重要性以防止長期握床所造成的後遺症，並藉著心肺復健的進行以提昇病患運動能力和生活品質。本篇介紹一位急性心肌炎合併心衰竭病患接受左心室輔助器（Heart Mate 1000JP,LVAD;Thermo Cardiosystems,Inc,Woburn,MA）置入術後進行整体性心肺復建計劃。其復健內容包括胸腔復健（包含固定式咳嗽（splint cough）、誘發呼吸運動、呼吸之訓練等......）和漸進性的行走訓練至跑步機訓練。最後病患心肺功能從紐約心臟協會功能第四級（NYHA Functional Class IV）進步到第一級（Class I），成功脫離左心室輔助器之使用。所以對人工心臟之使用患者而言，整体的心肺復健是必要且安全的；藉著復健計劃的實施，病患可改善其運動功能及生活品質並且在接受心臟移植後有較佳的預後。

關鍵字

心肺復健；左心室輔助器；運動測試

並列摘要

Patients bridging to transplantation with left ventricular assist device ( LVAD) often require prolonged support of ventricular assistance. As improving perioperative survial with LVAD, additional emphasis must be placed on patients' cardiopulmonary rehabilitation to prevent the occurrence of the deterious effect of bedrest ( such as ”immobilization syndrome”) and improve their exercise capability and life of quality. In this study,we proposed one case undergoing implantation of LVAD (Heart Mate) because of acute myocarditis complicated with end-stage heart failure. After LVAD insertion, the patient received cardiopulmonary rehabilitation. The program consisted of chest physical therapy(including splint cough, incentive spirometry exercise, breathing exercise)and progressive mobilization leading to treadmill exercise. The patient also received exercise testing for functional evaluation. The patient improved in cardiac function from NYHA Functional Class IV to Class I after rehabilitation and was successful in removing LVAD. In conclusion, early cardiopulmonary rehabilitation of LVAD patient is essential and safe. Patients with LVAD should be encourage to attend rehabilitation program for improving exercise capability & life of quality and better prognosis after heart transplantation.

並列關鍵字

cardiopulmonary rehabilitation ； left ventricular assist device ； exercise stressing

國際替代計量

使用左心室輔助器患者之心肺復健：病例報告

未授權

主題瀏覽