王艳盼

【摘  要】我国心血管病的患病率及病死率仍 处于上升阶段。最新发布的《中国心血管病报告 2016》指出，心血管病死亡占城乡居民总死亡原因的 首位，高于肿瘤和其他疾病^[1]。然而，美国、德国、 日本等发达国家的心血管病风险却在逐年下降^[2] ，主要 原因在于心血管病的预防和康复环节尚未引起重视。 心脏康复早已提出，且近几年的影响力得到不断提升，但是普及范围仍很局限，目前多集中于二三级大医院，社区医院开展心脏康复却寥寥无几。心脏康复的疗效已被证实，为提高全民心脏康复的认识及更好的做到防治康的统一，社区开展心脏康复是势在必行的。

【关键词】心血管疾病、心脏康复、社区、二级预防 慢病管理

【中图分类号】R198      【文献标识码】A      【文章编号】1004-7484（2019）07-0282-02

【Abstract】The morbidity and mortality of cardiovascular diseases in China are still on the rise. The latest China Cardiovascular Disease Report 2016 points out that cardiovascular disease death accounts for the first cause of death in urban and rural residents， higher than cancer and other diseases. However， the risk of cardiovascular disease in developed countries such as the United States， Germany and Japan is declining year by year. The main reason is that the prevention and rehabilitation of cardiovascular disease has not been paid attention to. Heart rehabilitation has been put forward for a long time， and its influence has been continuously improved in recent years. However， its popularity is still limited. At present， it is mostly concentrated in the second and third class hospitals， but few community hospitals carry out heart rehabilitation. The curative effect of cardiac rehabilitation has been confirmed. It is imperative for the community to carry out cardiac rehabilitation in order to improve the understanding of cardiac rehabilitation and better achieve the unity of prevention and treatment.

【Key words】Cardiovascular disease， cardiac rehabilitation， community， secondary prevention

心脏早期康复已被实践证实可以提高心血管病患者的运动耐受能力; 提高患者生活质量;降低心血管病的病死率和疾病 的总死亡率 。然而“心脏康复”这个词，对于我国许多心血管病患者及其家属还很陌生。在临床诊疗实践中，患者和 醫务人员多重视“放支架”“做搭桥”，即介入手术， 而很少关注疾病的预防和病后的康复。患者出院后 经常是无人管理，导致部分患者反复住院、反复进 行介入手术。增加了患者的心理负担，同时也增加了家庭经济负担，同时也是对医疗资源的浪费。

心脏康复的目的：1调整身体和精神的不适应，使之早 日康复出院;2预防疾病再复发;3提高生活质量。 临床上已 诊断冠心病的患者发生心肌梗死的危险性是无冠心病患者 的 5～7 倍，冠心病二级预防的目标也主要集中在预防高危患 者的心脏事件复发和心脏死亡。……