老年慢性心力衰竭全周期康复专家共识  

Expert Consensus on Full-Cycle Rehabilitation for Elderly Patients with Chronic Heart Failure

作　　者：何竟[1] 贾杰[2] 陈欣[3] 董安琴 丁毅鹏[5] 廖维靖[6] 郑洁皎[7] 余滨宾[8] 陈作兵[9] 房圆[10] 姚黎清[11] 朱一平 蒋泽武 李磊[1] 张秀 任玲[1] HE Jing;JIA Jie;CHEN Xin;DONG Anqin;DING Yipeng;LIAO Weijing;ZHENG Jiejiao;YU Binbing;CHEN Zuobing;FANG Yuan;YAO Liqing;ZHU Yiping;JIANG Zewu;LI Lei;ZHANG Xiu;REN Ling(West China Hospital,Sichuan University,Chengdu,Sichuan 610041,China;Huashan Hospital Affiliated to Fudan University,Shanghai 200040,China;Sino-Japanese Friendship Hospital,Beijing 100029,China;The Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450015,China;Hainan Provincial People's Hospital,Haikou,Hainan 570311,China;Zhongnan Hospital of Wuhan University,Wuhan,Hubei 430071,China;Huadong Hospital Affiliated to Fudan University,Shanghai 201104,China;Jiangsu Provincial People's Hospital,Nanjing,Jiangsu 210029,China;The First Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou,Zhejiang 311100,China;Shanghai Mental Health Center,Shanghai 200122,China;The Second Affiliated Hospital of Kunming Medical University,Kunming,Yunnan 650101,China;Shaanxi Provincial Rehabilitation Hospital,Xi'an,Shaanxi 710065,China)

机构地区：[1]四川大学华西医院,四川成都610041 [2]复旦大学附属华山医院,上海200040 [3]中日友好医院,北京100029 [4]郑州大学第五附属医院,河南郑州450015 [5]海南省人民医院,海南海口570311 [6]武汉大学中南医院,湖北武汉430071 [7]复旦大学附属华东医院,上海201104 [8]江苏省人民医院,江苏南京210029 [9]浙江大学医学院附属第一医院,浙江杭州311100 [10]上海市精神卫生中心,上海200122 [11]昆明医科大学第二附属医院,云南昆明650101 [12]陕西省康复医院,陕西西安710065

出　　处：《康复学报》2025年第2期112-123,共12页Rehabilitation Medicine

基　　金：国家重点研发计划项目(2018YFC2002304)。

摘　　要：心力衰竭(HF)是各种心脏疾病的严重表现或晚期阶段。慢性HF具有较高的患病率,接受标准药物治疗后,仍面临诸多生理、心理和社会问题。规范的康复治疗可以减轻患者功能障碍程度和提升生活质量。为进一步规范老年慢性HF诊断、康复评定和康复治疗的学术性指导和临床实践,特制订《老年慢性心力衰竭全周期康复专家共识》。本共识就老年慢性HF定义、病因、分类、分期与分级、全周期康复工作模式及其管理流程、功能障碍全周期康复评估、康复评定方法、康复治疗等进行规范。康复全周期包括疾病全周期、参与人员全周期、分级诊疗全周期和不同地区全周期4个层面。本共识详细介绍了老年慢性HF患者功能障碍特点(心功能、肺功能、运动功能、认知功能、精神心理功能、疼痛和感知功能等功能障碍)、康复评估与治疗方法;提出应在康复评估基础上,依据患者的具体情况制订个性化方案,包括有氧运动、抗阻训练、吸气肌训练、呼吸训练、认知功能训练、精神心理支持等。Heart failure(HF)represents a severe manifestation or critical stage in the spectrum of cardiac diseases.Chronic HF has a relatively high prevalence,posing significant physiological,psychological,and social challenges to patients despite optimal medical management.Evidence supports the efficacy of standardized rehabilitation programs in mitigating functional limitations and enhancing the quality of life for these patients.In response,the"Expert Consensus on Full-Cycle Rehabilitation for Elderly Patients with Chronic Heart Failure"has been developed to further standardize the academic guidance and clinical practices regarding diagnosis,assessment,and treatment of chronic HF in the elderly.This consensus document delineates a structured approach to the definition,etiology,classification,staging,and grading of chronic HF in the elderly.It outlines a full-cycle rehabilitation work model,encompassing management processes,assessment of functional impairments,rehabilitation evaluations and therapeutic interventions.The full cycle rehabilitation model emphasizes a holistic rehabilitation cycle that addresses the entire disease trajectory,involves all relevant stakeholders,integrates tiered diagnostic and treatment approaches,and is adaptable across various geographical settings.This consensus elaborates in detail on the characteristics of functional impairments in elderly patients with chronic HF(cardiac function,pulmonary function,motor function,cognitive function,mental function,pain,dysfunction of defecation and urination,sensory and cognitive dysfunction,etc.),as well as the rehabilitation assessment and treatment methods.It is proposed that based on the rehabilitation assessment,personalized programs should be developed according to the specific conditions of the patients,including aerobic exercise,resistance training,inspiratory muscle training,breathing training,cognitive function training,mental and psychological support,etc.

关 键 词：慢性心力衰竭 心脏康复 全周期康复 康复评估 运动训练 专家共识 

分 类 号：R541.6[医药卫生—心血管疾病]