下肢動脈血管繞道手術術後之下肢運動訓練介紹

下肢週邊動脈疾病（peripheral artery disease of the low extremities）是指下肢動脈血管粥狀硬化、狹窄或因血栓掉落，所引起的組織缺血。目前下肢周邊動脈阻塞經運動、飲食調整與傳統藥物治療後仍嚴重缺血者，使用血管整形術或繞道手術來進行血管重建治療則是目前最佳的治療法。接受下肢血管重建治療病人，術後常會出現瘀青與疼痛的問題，或者發生穿刺部位出現血腫的合併症，阻礙病人術後復健運動的進行，導致骨骼肌肉逐漸失去支撐力量，延長住院時間。本文依據下肢運動常用肌群為基礎，考量繞道手術術後下肢傷口，設計臥床姿勢即可進行的下肢肌力訓練之復健運動，例如：髖關節運動、膝關節運動與踝關節運動等，每周進行3～5 天，每天30～50 分鐘。上述運動不僅增進病人術後下肢肌力的恢復，更緩解術後傷口水腫情形減輕疼痛。所設計之運動未來可做為下肢動脈血管重建術後照護復健運動之參考。

關鍵字

下肢周邊動脈疾病；動脈血管繞道手術；下肢運動計劃

並列摘要

The low extremities peripheral artery disease (PAD) involves thickening of artery walls, which results from atherosclerosis, narrowing or thrombus of arteries. The treatment for peripheral artery disease includes risk factor modification, antiplatelet agent therapy, as well as exercise and nutritional therapy. Optimal therapy for critical limb ischemia is revascularization via bypass surgery or endovascular procedure. However, the majority of postoperative patients refuse to walk for the reasons of postoperative wound ecchymosis, swelling, hematoma and pain, which impede the rehabilitation recovery. Accordingly, this review will consider the property of wound healing and major muscles of low leg movement while planning the low leg exercise on bed to decrease wound swelling and facilitate muscle power of lower extremities, including exercise of hip joint, knee and ankle, which would be done 3-5 days/week, and 30-50 minutes/day. Therefore, we plan to establish an appropriate lower extremity exercise to meliorate the clinical signs of the patients’ lower extremities.

並列關鍵字

low extremities peripheral arfery disease ； arterial bypass graft surgery ； leg exercise program

參考文獻

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Chang, N. T., Chan, C. L., Lu, Y. T., Hsu, J. C., Hsu, Y. N., Chu, D., & Yang, N. P. (2013). Invasively-treated incidence of lower extremity peripheral arterial disease and associated factors in Taiwan: 2000-2011 nationwide hospitalized data analysis. BMC Public Health, 13(1), 1107. Doi:10.1186/1471-2458-13-1107

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下肢動脈血管繞道手術術後之下肢運動訓練介紹

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