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<title>心不全患者に寄り添う 包括的心臓リハビリテーションを極める（電子版のみ） | 株式会社文光堂</title>


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<meta name="description" content="心不全治療において，運動療法の有効性は予後改善だけでなく，運動耐容能の改善，繰り返し入院の予防，QOLの改善など多岐に渡っている．また生活指導，患者教育，カウンセリングを含む多職種介入もきわめて重要であることが指摘されており，これは包括的心臓リハビリテーションの概念と完全に一致している．したがって，包括的心臓リハビリテーションは不可欠であり，標準治療の一つとなるべきであるが，その普及の程度は小さく">

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	<section class="book">

		<h1 class="catchCopy">これぞ包括的心臓リハビリテーション取り組みの羅針盤！</h1>
		

		<h2 class="series">Management of Heart Failure&nbsp;&nbsp;</h2>
		
		<h1 class="title">心不全患者に寄り添う 包括的心臓リハビリテーションを極める（電子版のみ）<span class="version"></span></h1>
		

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					編集：絹川真太郎（北海道大学講師）
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					監修：松﨑益德（医療法人 聖比留会 会長）
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					責任編集：伊藤　浩（岡山大学教授）
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					<span class="transparent">責任編集</span>　筒井裕之（北海道大学教授）
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				<ul class="property"><li class="disc">A5判・168頁・2色刷</li><li class="disc">ISBN&nbsp;978-4-8306-1963-2</li><li class="disc">2016年3月1日発行</li></ul>

				
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		<div class="headers"><h3 class="current content">内容</h3><h3 class="preface">序文</h3><h3 class="indexes">主要目次</h3></div><section class="current content">心不全治療において，運動療法の有効性は予後改善だけでなく，運動耐容能の改善，繰り返し入院の予防，QOLの改善など多岐に渡っている．また生活指導，患者教育，カウンセリングを含む多職種介入もきわめて重要であることが指摘されており，これは包括的心臓リハビリテーションの概念と完全に一致している．したがって，包括的心臓リハビリテーションは不可欠であり，標準治療の一つとなるべきであるが，その普及の程度は小さく，ほとんど行われていないのが現状である．本書では心臓リハビリテーションに対して，特に医師がどのように取り組むべきかを明確に示唆する内容となっている．</section><section class="preface">序文<br><br>　人口の高齢化や生活習慣病の増加により心不全患者は増え続けている．今後さらにこの増加のスピードは増すことが予想されている．近年の大規模臨床試験の結果により，心不全に対する薬物治療および非薬物治療の予後改善効果が明らかとなった一方で，心不全の繰り返し入院やQOLの低下によって，医療コストの増大を含めて社会的な問題となっている．このような状況で，新たな心不全治療の開発は重要であるが，これまでの標準治療の普及は早急に行うべき課題である．<br>　心不全に対する運動療法の有効性はこれまでの研究によって明らかにされており，この効果は予後改善だけでなく，運動耐容能の改善，繰り返し入院の予防，QOLの改善など多岐にわたっている． また， 心不全治療において生活指導， 患者教育，カウンセリングを含む多職種介入はきわめて重要であることが指摘されているが，この概念は包括的な心臓リハビリテーションと完全に一致している．したがって，運動療法を含む多職種による包括的心臓リハビリテーションは心不全治療に不可欠であり，標準治療の一つではないだろうか．しかしながら，本邦においてその普及の程度は小さく，ほとんど行われていないのが現状である．<br>　本書では，心不全のみを対象とした包括的心臓リハビリテーションに絞り，これまでにない深く掘り下げた内容にした．まず，心臓リハビリテーションが全身管理を必要とする心不全治療にいかに大切であるかを解説し，次に，心不全の運動耐容能の規定因子や評価指標から具体的な運動処方までを解説するようにした．その際，監視下だけでなく，長期間・普遍的に運動ができるように非監視下の運動処方をいかに行うかも盛り込んだ．さらに，さまざまな心不全の病態に対する心臓リハビリテーションについても施設の経験も交えて解説いただき，最後に，心臓リハビリテーションの要である多職種からみた心臓リハビリテーションを解説していただいた．特に，心臓リハビリテーションの発展には医師や理学療法士だけではなく，看護師，薬剤師，栄養士，臨床心理士の関与が重要である点を強調した．また，コラムを複数設けて，心臓リハビリテーションのエビデンスの構築，普及のための方策，基礎的な検討，エビデンスが十分でない病態への取り組み，そしてチームビルディングなどを盛り込み，心臓リハビリテーションに対して我々がどのように取り組むべきかを示唆する内容とした．<br>　循環器に関わるすべての医師および多職種の医療者を読者対象としたが，循環器専門医の先生にも手にしていただき，あらためて心臓リハビリテーションの重要性を認識し，今後の発展の礎を作るきっかけとなることを願っている．<br><br>2016年3月<br>北海道大学　絹川真太郎</section><section class="indexes">I 全身管理としての心臓リハビリテーション<br>　1 心不全の病態と運動療法の身体的効果<br>　2 心不全の病態と運動療法のQOLや精神面に及ぼす効果<br>　3 心不全における疾病管理プログラム<br>　4 心不全に対する心臓リハビリテーションのエビデンス<br>コラム<br>　リハビリテーションのエビデンス構築に必要な点<br>　心不全に対する心臓リハビリテーションを普及させるためにはどうしたらよいか？<br>II 運動耐容能と運動処方<br>　1　心不全における運動耐容能規定因子<br>　2　心肺運動負荷試験（CPX）を用いた心不全における運動耐容能指標<br>　3　心不全における運動処方<br>　4　心不全におけるレジスタンストレーニング<br>　5　非監視下運動時の運動処方<br>コラム<br>　心不全における骨格筋異常の基礎的検討<br>　CPXを用いた労作時息切れの鑑別<br>III さまざまな心不全の病態に対する心臓リハビリテーション<br>　1　左室駆出率が保持された心不全（HFpEF）<br>　2　サルコペニアを合併した心不全<br>　3　全身合併症を有する心不全<br>　4　CRT・ICD植え込み後<br>　5　補助人工心臓植え込み後，心臓移植後<br>コラム<br>　高齢心不全患者に対する運動療法<br>　強心薬投与中の心臓リハビリテーション─いつから開始する？─<br>　肺動脈性肺高血圧症患者に対する心臓リハビリテーション<br>IV 多職種からみた心不全に対する心臓リハビリテーション<br>　1　看護師<br>　2　理学療法士<br>　3　薬剤師<br>　4　管理栄養士<br>　5　臨床心理士<br>コラム<br>　多職種チームビルディングとカンファレンス<br>索引</section></article>
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