After coronary artery bypass grafting, the blood supply to the heart has been greatly improved. The next most important treatment is to participate in cardiac rehabilitation program, check regularly, control the risk factors of coronary heart disease, learn good lifestyle and eating habits, and master the correct exercise methods, so as to keep the coronary artery unobstructed, improve and improve cardiac function, and reduce the recurrence of coronary restenosis.
Review after heart bypass surgery
The review time after heart bypass surgery can be determined according to the operation situation. Generally speaking, the patients were followed up once every month, 3 months, 6 months and 1 year after operation. Check blood lipid and liver function regularly, and check heart ultrasound every year.
It is necessary to control the risk factors of coronary heart disease after heart bypass surgery, such as smoking, hyperlipidemia, diabetes and hypertension.
You need to continue taking medicine after heart bypass surgery.
Aspirin enteric-coated tablets and isosorbide mononitrate tablets need to be taken for life. Take Habenade for a year first. You can take betaloc orally for 3 months first. Simvastatin tablets should be taken according to your blood lipid level. Others are taken according to the situation.
After coronary artery bypass grafting, it is often necessary to continue to take vasodilators for a period of time according to the different conditions of patients, such as nitrates, calcium antagonists, beta blockers, such as aminoacylpropranolol and metoprolol, anticoagulants such as aspirin, bolivar and digitalis such as digoxin. Diuretics: such as furosemide. Take the medicine quantitatively and on time according to the doctor's advice, and don't stop taking it casually. When taking medicine, you should pay attention to the side effects of the medicine. Take nitroglycerin with you when you go out to prevent angina pectoris. If the onset of pain lasts for more than 30 min, and the drug-containing effect is not good, the occurrence of myocardial infarction should be considered, and the nearest doctor should be sought quickly to avoid delaying the treatment and rescue opportunity. If you are complicated with hyperlipidemia or hypertension, you should insist on taking drugs to reduce blood lipid and blood sugar under the guidance of a doctor to control the development of related diseases and ensure the comprehensive recovery after coronary artery bypass grafting.
Diet after coronary artery bypass surgery
1, low sodium diet. Low sodium diet should eat less pickled or smoked food; It is advisable to eat less canned food.
2. Low-fat diet. Diet should limit the intake of animal fat. Vegetable oil should be used more when cooking, and cholesterol should be limited to below 300 mg per day. Bean products are the first choice of lipid-lowering foods. Auricularia auricula has the effects of resisting platelet aggregation, reducing blood lipid and preventing blood cholesterol deposition. Wild oats, oats and barley are the best products to reduce blood fat, which can reduce blood cholesterol and reverse fatty liver.
3, moderate intake of protein. Unless complicated with chronic renal insufficiency, there is generally no need to strictly limit the intake of protein. Eating fish protein 23 times a week can improve blood vessel elasticity and permeability, increase urine and sodium excretion, and thus lower blood pressure.
4. Eating more green vegetables and fresh fruits is beneficial to myocardial metabolism, improving myocardial function and blood circulation, promoting cholesterol excretion and preventing the development of hypertension.
5. Avoid foods that irritate the nervous system, such as wine, strong tea and coffee. Smoking is very harmful to the heart, because (1) cigarettes contain tar, nicotine and carbon monoxide, which is very harmful to the human body. (2) When the concentration of carbon monoxide and hemoglobin in the blood is too high, the blood oxygen concentration will decrease, the oxygen supply to the tissue will be insufficient, the inner wall of the artery will be edematous, the endothelium will be damaged, and the lipid will penetrate into the blood vessel wall, which will accelerate the formation of atherosclerosis. (3) In patients with coronary heart disease, smoking will accelerate the progress of the disease and cause a heart attack. Heavy smoking can induce severe arrhythmia such as ventricular fibrillation and become one of the causes of sudden death.
Matters needing attention in exercise after heart bypass surgery
Exercise prescription must be made for rehabilitation after coronary artery bypass grafting. Because patients with coronary artery bypass grafting have different preoperative symptoms and different levels of cardiac function, it is necessary to have individualized guidance and rehabilitation exercise by medical staff after operation.
Any exercise prescription should be formulated according to factors such as disease diagnosis, health status, functional status of cardiovascular and motor organs, age, gender, exercise history and hobbies. According to the recovery after coronary artery bypass grafting and whether there are complications, choose the appropriate exercise mode and amount. In a word, the rehabilitation exercise prescription should emphasize individualization.
Exercise prescription is also called training exercise plan. The rehabilitation exercise of patients after coronary artery bypass grafting must make exercise prescriptions, which should be carefully aligned as drug prescriptions. Exercise prescription includes exercise type, intensity, duration, frequency and progress speed.
(1) Exercise type: The purpose of rehabilitation exercise is to obtain and maintain normal physical activity ability. Whether this effect can be achieved depends on several basic factors, including cardiopulmonary tolerance, body structure (percentage of fat in body weight), muscle strength and endurance, and joint flexibility. The most important thing for patients after coronary artery bypass grafting is to enhance the tolerance of heart and lung. Aerobic endurance activities can improve the tolerance of the heart and lungs, which are divided into two groups:
The first group: Physical activities are characterized by low exercise intensity and little change in heart rate, such as walking, jogging, climbing stairs, riding an exercise bike, training with various equipment to do various aerobics, playing Tai Ji Chuan in ruins, dancing Tai Chi sword, etc.
The second group: Physical activities are characterized by physical activities that are persistent and difficult to maintain, such as dancing, games, ball games and other activities.
(2) Exercise intensity: Exercise intensity refers to the amount of exercise in a certain period of time. Improving the endurance of cardiovascular system requires a certain intensity of exercise. Exercise intensity needs proper monitoring to determine whether it is appropriate, which is the most difficult part of designing exercise prescription. In medical rehabilitation, exercise intensity can be determined according to metabolic indexes such as heart rate, maximal oxygen uptake and degree of consciousness fatigue. Among these indicators, the maximum oxygen uptake is the most difficult to achieve. The relationship between heart rate and exercise intensity is linear and proportional. However, patients after coronary artery bypass grafting should take drugs for a long time, such as calcium antagonists, which have an impact on heart rate and cannot objectively reflect exercise intensity. We suggest that patients after coronary artery bypass grafting should use the level of talking exercise to master the intensity of exercise.
Talking about the level of exercise: talking during exercise, without obvious shortness of breath, is an exercise intensity suitable for training. If you can sing during exercise, it means that the exercise intensity is not strong enough.
(3) Exercise duration: refers to the time required for a rehabilitation training. It can be divided into three stages: adaptation activities, cardiopulmonary endurance training and relaxation activities. The time required for the three stages is: 5- 10 minutes; 20-30 minutes; 5- 10 minutes. Adaptive activities include joint flexion and extension, and gradually increase the amount of exercise. It can avoid sudden high-intensity exercise of myocardial ischemia and prevent muscle and joint injury. For patients with poor health after coronary artery bypass grafting, adaptive activities should be extended appropriately. Cardiopulmonary endurance training is intensive, so the time for patients who take part in exercise for the first time should not exceed 10- 15 minutes. Relaxing exercise is to reduce the discomfort after exercise. At the beginning of relaxation exercise and during the activity, the heart rate should quickly return to normal. If the heart rate recovers slowly during relaxation exercise, the intensity of exercise should be reduced appropriately according to the situation.
(4) Exercise frequency: Exercise of patients after CABG. At first, we suggested intermittent exercise. Intermittent exercise takes place alternately with exercise and rest, but the cumulative exercise time shall not be less than the prescribed continuous exercise time, and the time ratio of exercise and rest is 1: 1.
The benefits of intermittent exercise for patients with coronary heart disease are:
1) patients achieve higher exercise intensity and feel less tired, because unlike continuous exercise, they can reduce the accumulation of lactic acid at rest.
2) There are many times of stimulation for heart training, mainly because we can repeat the political views on cardiac stroke volume, venous reflux and intracardiac pressure.
Exercise frequency refers to the number of rehabilitation exercises per week. In order to achieve the expected effect of rehabilitation exercise, patients should exercise at least three times a week, and the interval between two exercises should not exceed 2 days. Patients who participate in exercise three times a week can improve their cardiopulmonary endurance to some extent after 2-3 weeks, and usually have a significant improvement after 6-8 weeks. At the same time, we emphasize that patients undergoing coronary artery bypass grafting must insist on exercise to maintain the effect of exercise. If the number of exercises is reduced to 1 time per week, the acquired cardiopulmonary adaptability will disappear by half within 10 week. If the activity is completely stopped, the patient will lose all the cardiopulmonary endurance gained within 5 weeks.
3) Progress of the exercise plan: The progress of the exercise plan depends on the individual's maximum physical ability, health status, age and goals. Cardiopulmonary endurance of exercise prescription can be divided into three stages, namely initial stage, improvement stage and maintenance stage.