胡大一--心脏康复

复PCI/CABGРBiv-pacing ICDР心脏移植Р医疗资源投入不足?使用不合理--->巨大浪费Р心脏康复/二级预防缺失Р无医保支持Р只“大修”不维护Р人的服务不如汽车Р心脏康复/二级预防发展史Р他山之石可以攻玉Р康复/二级预防 50年Р1700SРDr. William Herberden Sr(1710-1801)Р英国医生Р首先描述心绞痛症状Р首次提出CVD患者运动Р“I knew a patient with angina pectoris,who set himself a task of sawing wood for half an hour every day, and was nearly cured”- 1771Р1800SРDr .Max Joseph Oertel (1835-1897)Р德国医生Р首先倡导“运动处方”Р逐渐增加运动是对血压、心率和健康状况的影响Р1900S 早期РDr. James Bryan Herrick(1861-1954)Р1912JAMA “Myocardial Infarction”(Landmark article)Р1918 首次建议用EKG诊断MIР建议MI患者卧床6-8周Р1930S,Mallry、White:进一步延长卧床Р1950SР1950S , Levine/Lowe 公开质疑MI长期卧床的必要Р1953 Louis Katrz AHA: 摒弃业已证实错误的旧传统,接受新理念Р1950S late: Terell/Hellerstein逐步增加运动量的分级心脏康复方案Р1960SР美国总统 Dwight Eisenhower 患MI?Prof. Paul Dudley White ? Graded Exercise(Swimming/Walking/Golf)?1960:众多研究显示长期卧床的弊病