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各位朋友：

大家好，现在是“每天健康三分钟”时间，我是道简-心血管康复医生集团的医生郑俊博，今天我来给大家讲讲心衰了还能不能运动。

心衰患者往往谨小慎微，顾虑重重，不敢运动。其实多数患者通过有规律的运动可明显改善心功能和生活质量，还能减少死亡的危险。关键是运动要适量，通过适量的运动或活动，患者心情舒畅，感到精力较为充沛，而且改善夜间睡眠。

如何运动也是有讲究的，下面咱们讲一讲。

01运动前要注意什么？测量运动前的脉搏，若每分钟脉搏超过100次，则不适合参加运动或活动。另外，运动前适当热身可以促进血管扩张。至少做10分钟伸展、慢走或其他活动。

02在什么时间活动比较好？一般情况下每天参加运动一次或两次，一次20-30分钟，宜在饭后2-3小时或饭前1小时进行。天气非常炎热时，可选在早晨或晚间进行。冬天宜在有太阳时进行，总之应选择不太寒冷也不太热的温度运动。

03做什么样的运动？

1.做力所能及的活动。心力衰竭患者在康复期应参与一些心脏能够承受的、力所能及的活动，但切忌操之过急。因为心衰患者的运动。和心脏功能与正常人相比有很大的区别。

2.从小量活动开始。心力衰竭患者康复期的运动和活动应从小最开始，慢慢增加，切忌过量。一开始应在家人或医护人员的陪同和监护下做些室内活动，能耐受后再移至室外。漫步的距离逐渐递增。

3.运动方式选择有氧阻抗运动：可以做行走、爬楼梯、游泳、骑自行车、跳慢三、慢四，打太极拳、太极剑等，也可以适当地做一些四肢及关节的活动，且活动时间不宜长。适当的力量运动可增强呼吸肌(膈肌和腹肌)的运动，减轻呼吸困难、改善生活质量、增强运动耐量。低重量阻力运动(如哑铃操等)可增强四肢和躯干肌群的力量，减轻疲乏，一般运动1～2组、每组重复12～15次即可使肌肉得到足够的锻炼。

4.勿做爆发性的运动或活动，如：突然眺跃、转体、提重物、抱小孩、启酒瓶盖、抛东西等。

04运动中要注意什么？运动或活动时监测症状。运动中若出现过度疲劳、胸闷、气短、心前区疼痛、头痛、恶心、面色苍白等症状时，表示心脏无法承受此运动量，应立即停止，并要充分休息。

05运动时间多久比较合适？理想的目标是患者在预期的心率范围内步行或就地蹬车30～40分钟（可以分成每节10分钟），每周3～5次。预期的心率为休息时心率+20次/分即可。

06运动后要注意什么？运动后要进行放松运动，以让肌肉逐渐舒缓，减轻运动后肌肉不适感。通过适量的运动或活动，患者能心情舒畅，感到情力较前充沛。夜间睡眠好，无其他不适症状，说明运动适度。若出现不适症状或睡眠差，表示运动或活动量过大，要减少运动量或调整运动方式。

要注意的是，开始运动前应采取药物治疗控制心衰。有条件的应到医院行心肺功能检测，以判断机体对运动的反应，决定安全有效的运动水平，并参照医生开具的运动处方进行运动。总之，药物与运动同时进行比单用一种措施更有效。对于几乎所有的心衰患者，系统的运动应为整体治疗的一部分。

最后祝大家生活愉快，身体健康！想了解更多心血管科普小知识，请关注我们，咱们下期见。

【英文版】

Can heart failure patients still exercise? The answers are all here

Dear friends, nice to meet you!Now it is time for “Health talk for three minutes every day”,My name is Zheng Junbo, a doctor of Daojian Doctor Group of Cardiovascular Rehabilitation.Today, I'd like to tell you whether patients with heart failure can exercise.

Patients with heart failure are often cautious, and they dare not exercise.In fact, most patients can significantly improve heart function and quality of life and reduce the risk of death through regular exercise. The key is to exercise properly, through the right amount of exercise or activity, patients will feel comfortable, more energetic than before, and their night sleep will also be improved.

How to exercise is very particular, next let's talk about it.

What should we pay attention to before exercise?

Measure the pulse before exercise. If the pulse is more than 100 beats per minute, it is not suitable to participate in sports or activities. In addition, warm-up before exercise can promote vasodilation. Do at least 10 minutes of stretching, walking or other activities.

When is the best time to take exercise?

In general, exercise once or twice a day for 20-30 minutes is OK, and it will be better to take exercise 2-3 hours after meals or 1 hour before meals. When the weather is very hot, it can be carried out in the morning or at night. Exercise should be carried out in the sun in winter. In short, you should choose the time not too cold or too hot to take exercises.

What kind of sports can you do?

Do what you can.

Patients with heart failure should take part in the activities that the heart can bear and do everything at your power during the recovery period,but do not act too fast. As the heart function of patients with heart failure are very different from those of normal people.

Start with small activities.

The exercise and activity of patients with heart failure in rehabilitation period should start from the minimum, and be increased slowly, excessive exercise should be avoid. At the beginning, you should do some indoor activities accompanied and supervised by family members or medical staff, and then move to the outdoor after you can tolerate it. The walking distance should be increased gradually.

Aerobic impedance exercise could be selected as the exercise mode.

You can do walking, climbing stairs, swimming, cycling, dancing slow three or slow four, playing Taijiquan, Taijijian, etc., and you can also properly do some activities of limbs and joints, and the activity time should not be long.Proper strength exercise can enhance the movement of respiratory muscle (diaphragm and abdominal muscle), reduce dyspnea, improve quality of life, and enhance exercise tolerance. Low weight resistance exercise (such as dumbbell exercise) can enhance the strength of limbs and trunk muscles, and reduce fatigue.Generally, exercise 1 or 2 groups, repeated 12 to 15 times in each group, can make muscles get enough exercise.

Do not do explosive sports or activities, such as sudden jumping, turning, lifting heavy objects, holding children, lifting wine bottle cap, throwing away

What should we pay attention to in sports?

Monitor symptoms during exercise or activity. If excessive fatigue, chest tightness, shortness of breath, precordial pain, headache, nausea, pale complexion and other symptoms occur during exercise,it means that the heart can not bear the amount of exercise, and you should stop immediately and have a full rest.

How long is it appropriate to exercise?

The ideal target is for patients to walk or pedal on the spot for 30 to 40 minutes (which can be pided into 10 minutes per session) within the expected heart rate range,3-5 times a week, and the expected heart rate is 20 beats / min more than that at rest.

What should we pay attention to after exercise?

After the exercise, it is necessary to carry out relaxation exercise, so as to gradually ease the muscles and reduce the discomfort after exercise.Through the appropriate amount of exercise or activity, patients can feel comfortable and feel more energetic than before.Good sleep at night without other discomfort symptoms indicates moderate exercise.If there are symptoms of discomfort or poor sleep, it means that the amount of exercise or activity is too large, you’d better reduce the amount of exercise or adjust the way of exercise.

It should be noted that before starting exercise, medication should be taken to control heart failure.

If possible, you should go to the hospital for cardiopulmonary function test to judge the body's response to exercise and determine the safe and effective level of exercise, and exercise according to the doctor's exercise prescription. In short, it is more effective to use drugs and exercise at the same time than one measure alone.For almost all patients with heart failure, systematic exercise should be part of the overall treatment.

Finally, I wish you all a happy life and good health!To learn more about cardiovascular disease, please pay attention to us. See you next time.