★  優活 健康網    ★  Living Well Website
  • 首頁
    • ● ER
    • ● 台灣 美食悠遊網
    • ● 台灣旅遊 導覽網
    • ● 生活智慧網
    • ● 台灣 消費者網站
    • ★ 中國 旅遊網
  • 美食
    • 美食
    • ● 火鍋美食 介紹 - Hot Pot
    • ● (麵食)- 牛肉麵、炸醬麵、拉麵 - Noodles
    • ● 豆腐類 美食 - Tofu Dishes
    • ● 香菇類 美食菜餚 - Mushroom
    • ● 馬鈴薯、土豆菜餚 - Potatoes
    • ● 潤餅卷, 春捲- Popiah, Egg Roll
    • ● 台灣便當飲食, 台鐵便當- Boxed meal
    • ● 台灣 滷肉飯 Braised Pork Rice
    • ● 台灣料理- 油飯、糯米 Glutinous oil rice
    • ● 日式料理- 蛋包飯, 關東煮 Japan cuisine
    • ● 日式料理 - 丼物 (蓋澆飯) (Donburi)
  • 購物
    • ▼ 商圈 ===> >
      • ● 台北市 西門町 商圈 Ximending B. District
      • ● 台北市 信義商圈- Taipei 101 Shopping
      • ● 台北市 五分埔商圈- Wufenpu Garment
      • ● 台北 重慶南路書店街 Taipei Bookstores
      • ● 台北光華商場- 數位新天地- Guanghua
    • ▼ 經濟 ===> >
      • ● 懂程式,會美編,在台新金只值21K
      • ● 師大夜市餐廳經營 - 我賺的錢 都給房東了
      • ● 越勞中國月賺900美元,偷渡來台只領22K
      • ● 美國醫療費用世界最昂貴- US medi-cost
      • ● 餐廳我賺的 都給房東了- High Rent
      • ● 經營
    • ● 台北101 購物中心-Taipei 101 shopping
    • ● 團購 -- Group Buying
    • ● 蘋果,宏達電,三星, 手機大戰- htc Apple
    • ● 台灣團購網騙很大 Groupon、Gomaji
    • ● 中國大陸團購分析-Group buying in China
  • 飲食
    • ● 糖份 - Sugar : The Bitter Truth
    • ● 好吃美食與健康危險- 警訊 - Food risk
    • ● 常吃泡麵有害身體健康
    • ● 當心水果食物中毒 - Food Poisoning
    • ● 不安全食物: 壽司被評為第一 - Sushi
    • ● 一舉兩得 - 外食族抗漲帶便當
    • ● 苦茶油 - Tea Seed Oil
    • ● 隔夜菜食用有何可能問題?
    • ● 長期不吃肉竟早衰失智
    • ● 飲食與癌症關係密切 - Diet and Cancer
    • ● 不含麩質飲食法的爭議- Gluten-free diet
    • ● 吃深海魚 小心汞中毒- Mercury poison
    • ● 老人愛管灌飲食, 恐營養失衡- Elderly
    • ● 手搖飲當水喝!兩壯年男中風 半邊癱瘓
  • 保健
    • ▼ 運動 ===> >
      • ● 運動健身好處多- Exercise for Health
      • ● 運動讓你每個細胞都健康 - Exercise
      • ● 慢跑運動 - Jogging Exercise
      • ● 活動:要活就要運動 - Exercise is Key
      • ● 有氧健身操課訓練 - Aerobics for health
    • ● 養生之道- 勿喝冰冷飲料- No cold drink
    • ● 小米, 燕麥, 糙米煮粥吃 改善胃潰瘍, 發炎
    • ● 網傳留言:亂吃東西中年以後會很痛苦
    • ● 葡萄糖胺食品保健?毒物醫師斥無效
    • ● 山竹果汁 - Mangosteen Juice
    • ● 滿街飲料店, 嚴重傷害台灣人健康-Hazard
    • ● 牛初乳奶粉不能直接用作嬰兒主食
    • ● 趁一切還來得及- 養生之道- Not too late
    • ● 國際藥聞- 醫學期刊: 別浪費錢買維他命
    • ● 顧他命可緩化療, 但沒療效- Glutamine
  • 保健
    • ● (三高) - 高血壓, 高血糖, 高血脂
    • ● 油漱法 Oil Pulling - 荒謬的保健法
    • ● 101歲劈腿爺,頭能頂地,腿可繞頸- 101 yr
    • ● 阿金博士減肥法 - Dr. Atkin's Diet
    • ● 最流行九種減肥飲食法- Weight loss diet
    • ● 膳食纖維的功能與重要 - Dietary Biber
    • ● 大燕麥片降膽固醇- Oatmeal
    • ● 清朝 乾隆皇帝的高壽秘訣
    • ● 冥想默思 (Meditation)
    • ● Health Benefits of Meditation
    • ● Unblock cholesterol plaqued arteries
  • 營養
    • ● 維生素缺乏症 - Vitamin Deficiency
    • ● 維生素A 缺乏症 - Vitamin A Deficiency
    • ● 維生素B1 (硫胺)缺乏 - Vitamin B1
    • ● 維生素B2 (核黃素) - Vitamin B2
    • ● 維生素B3 (菸鹼酸) - Vitamin B3
    • ● 維生素B5 (pantothenic acid)
    • ● 維生素B6
    • ● 維生素B9 (葉酸) 缺乏- Folic Acid
    • ● 維生素B12 缺乏症- Vit B12 Deficiency
    • ● 維生素B12 - Vitamin B12
    • ● 維生素C 缺乏症 - Vitamin C Deficiency
    • ● 維生素D 缺乏症 - Vitamin D Deficiency
    • ● 維生素E 缺乏症 - Vitamin E Deficiency
    • ● 維生素 K - Vitamin K
    • ● 補鉀降低心腦血管疾病風險 - Potassium
    • ● 補鈣不能盲目,腎不好補鈣會傷害心臟
  • 營養
    • ● 魚油 - Fish oil
    • ● 魚肝油 - Cod Liver Oil
    • ● 二十二碳六烯酸 - DHA
    • ● 水果的營養 - Fruit Nutrition
    • ● 抗氧化劑 Anti-Oxidant
    • ● 薑黃素(Curcumin) - 咖哩 Curry
    • ● 人體缺乏維生素B2與得患癌症有關
    • ● 中老年人喝牛奶能降低心血管疾病
    • ● Milk Myth - 牛奶迷思
    • ● Nutrition value- Juice vs. Concentrate
    • ● Benefits of Orange Juice
    • ● Nutrition & Food - Google Tech Talks
    • ● Selenium 硒元素
  • 健康
    • ▼ Health ===> >
      • ● Vitamin E Tied to Prostate Cancer Risk
      • ● Nutrition and Immune System
      • ● Our Microbes in Us
      • ● Nutrients that Boost Immunity
      • ● Exercise and Aging
      • ● Leg Cramps While Sleeping
    • ● 營養健康補品 - 初乳 - Colostrum
    • ● 關於蜂蜜 - 一個真實的故事 - Honey Story
    • ● 科學家研究咖啡因, 發現利弊參半-Coffee
    • ● 震驚世界的醫學發現!Awesome discovery
    • ● 十大健康惡習- Top 10 unhealthy habits
    • ● 服用維他命有助健康? 效果具爭議-Vitamin
    • ● 健康飲食就要從飲食中少油做起- Less oil
    • ● 手腳冰冷,恐潛藏健康問題-
    • ● 猛灌紅茶不喝水,壯男中風半癱
    • ● 如何減肥瘦身 - Lose Body Weight
    • ● 肌肉減少症- 骨骼肌減少症- Sarcopeni
    • ● 怎樣測試自己是酸性體質或鹼性體質?
    • ● 烘烤炸澱粉食物易生致癌物
    • ● 枸杞與眼睛健康
    • ● 瀋陽男1夜喝20瓶啤酒, 胰臟溶解只剩一層膜
  • 健康
    • ● 人體胃的生理功能與病症
    • ● 小腸的生理功能與病變
    • ● 大腸的生理功能與病變
    • ● 如何提升人體免疫力 - Enhance Immunity
    • ● 保衛人體健康免疫系統- Immunity
    • ● 穀胱甘肽- Glutathione- (Antioxidant)
    • ● 咳嗽3週才會好 別急吃抗生素
    • ● 如何保持你的腸道健康 - Healthy Guts
    • ● 緩解疼痛的策略: 雙臂交叉?Cross arms
    • ● 睡眠改善高血糖-Sleep lower blood sugar
    • ● 心因性猝死,1個月前會出現徵兆- Cardiac
    • ● 預防髖部骨折,補充鈣與維生素D- Pelvis
    • ● 肉類攝取與罹患癌症的風險
    • ● 雞蛋與第二型糖尿病發生機率
    • ● 鉀離子與身體健康 - K+
    • ● 姿勢性低血壓 Orthostatic Hypotension
  • 檢查
    • ▼ 驗血 ===> >
      • ● 驗血 - 全血細胞計數 - CBC
      • ● 癌症指數的正確閱讀
      • ● 抗體 Antibody (Immunoglobulin)
      • ● Serum Free Light Chains -血清遊離輕鏈
      • ● Beta 2-Microglobulin (β2-M)
    • ● 膀胱(內視)鏡檢查 - Cystoscopy
    • ● 大腸(內視)鏡檢查與結腸瘜肉
    • ● 超音波掃瞄檢查- Ultrasound scan
    • ● 孕婦超音波- Pregnancy ultrasound
    • ● 心臟病檢查
    • ● 肌電圖 檢查- Electromyography
    • ● 腎功能檢查 - Kidney Function Tests
    • ● 紅血球與貧血 (RBC & Anemia)
    • ● 尿液分析檢驗 - Urine Test
    • ● 胸部X光檢查 - Chest X-ray
    • ● 血壓與血壓測量 - Blood Pressure
    • ● 泌尿科常做的檢查
  • 病症
    • ▼ 胃腸病 ===> >
      • ● 胃食道逆流病 - GERD, Reflux Disease
      • ● 慢性胃炎 - Chronic Gastritis
      • ● 胃黏膜-腸上皮化生 Intestinal Metaplasia
      • ● 非潰瘍性消化不良- Nonulcer dyspepsia
      • ● 下一個國民病大腸癌? 如何發現徵兆?
      • ● 胰臟炎與胰臟疾病 - Pancreatitis
    • ▼ 癌症 ===> >
      • ● 癌症免疫療法- Cancer Immunotherapy
      • ● 多發性骨髓瘤 - Multiple Myeloma
      • ● 胰臟癌 - Pancreatic Cancer
      • ● 淋巴瘤 - Lymphoma
      • ● 泌尿道癌症
      • ● 膀胱癌 - Bladder Cancer
      • ● 肝癌 - Liver Cancer
      • ● 食道癌 - Esophageal Cancer
    • ▼ 症狀 >
      • ● 血尿
    • ● 阿茲海默氏症 Alzheimer D. (老年癡呆症)
    • ● 如何預防老年癡呆症 -
    • ● 如何預防失智症 -
    • ● 重肌無力症 - Myasthenia Gravis
    • ● What's Causing Your Memory Loss?
    • ● Level of GFR and Anemia
    • ● 低鈉血症 - Hyponatremia
    • ● 體液與血鈉異常之處置
    • ● 低血鉀症 - hypokalemia
    • ● 高血鉀症 - hyperkalemia
    • ● 低鉀血症和高鉀血症
    • ● 酸血症 - Acidemia - 代謝性酸中毒
    • ● 低鈣血症 - Hypocalcemia
  • 醫療
    • ▼ 健保 ===> >
      • ● 中央健康保險署 - 台灣二代健保
      • ● 台灣二代健保
      • ● 台灣全民健保與急診醫療 - ER
      • ● 健保藥費核價離譜- 同成分藥劑,價差逾2倍
      • ● 全民健保老人整合門診,家屬大多不知道
      • ● 台灣的醫療安全問題 -
    • ▼ 心臟病 ===> >
      • ● 心肌梗塞 - Heart Attack Signs
      • ● 心臟病 體外反搏治療- EECP Therapy
      • ● 體外「心臟震波」治療冠心病 - CSWT
    • ▼ 眼科 ===> (眼睛健康與保養) >
      • ● 中老年人眼睛與視力問題- Eye disease
      • ● 眼睛 白內障 (Cataract)
      • ● 眼睛 白內障的治療 - Cataract
    • ● (好書推薦):最新天星英漢百科醫學辭典
    • ● 乳房腫塊以為瘀青, 推拿推到癌細胞擴散
    • ● 葡萄糖胺療效淺,破除維骨力神話
    • ● 腳跟疼痛?千萬別輕忽
    • ● 中醫經方療效不顯,專家: 中藥用量該多大
    • ● 你相信「中醫」有多少療效?
    • ● 多發感覺運動神經病變-polyneuropathy
    • ● 腳麻走不動?你可能需要神經傳導檢查
    • ● 成大揪肝硬化元凶,治肝大突破
    • ● 臨床打針注射技術
    • ● 鼻胃管 - Nasogastric Tube
  • 醫療
    • ● 血尿 Hematuria
    • ● 泌尿道感染 - 膀胱炎- Cystitis
    • ● 憂鬱症 - Depression (Mood)
    • ● 流感重症合併,肺炎感染驟增
    • ● 老人骨質疏鬆症, 逾半數有骨折- Fracture
    • ● 骨質疏鬆症與防治 - Osteoporosis
    • ● 安慰藥效果 - Placebo Effect
    • ● 帕金森氏症 - Parkinson's Disease
    • ● 帕金森氏症治療 - Parkinson Treatment
    • ● 帕金森氏症與睡眠失常
    • ● Glutathione
    • ● 達文西機械手臂手術- da Vinci Surgery
    • ● 高血壓治療
  • 腎病
    • ▼ 腎病藥物 ===> >
      • ● 活性炭 克裏美淨(Kremezin) 效果如何
      • ● 活性炭 克裏美淨(Kremezin)效果不明顯
      • ● 吉多利錠- Keto-analogues for CKD
    • ● Sodium Bicarbonate Heals Kidney D.
    • ● Sodium Bicarbonate Cures Cancer
    • ● 腎血管肌肉脂肪瘤
    • ● 泌尿道感染 尿道炎 基本知識
    • ● 如何保護你的腎臟-Protect your kidneys
    • ● 腎臟微循環與其內在調節 (急診醫學)
    • ● 人體內水與電解質的平衡 (急診醫學)
    • ● 腎臟炎的(飲食)治療處理
    • ● 腎臟病患者飲食原則與禁忌- Kidney D.
    • ● 腎臟病與蛋白質的攝取
    • ● 如何保護腎臟?遠離慢性腎臟病
    • ● 腎衰竭患者的飲食
    • ● 逆轉腎!低蛋白搭酮酸胺延緩洗腎
    • ● 洗腎病患營養與飲食原則
    • ● (腎臟) 透析 (Dialysis) -- 洗腎
    • ● Pentoxifylline 與慢性腎臟病
    • ● Healthy Foods for Kidney Disease
    • ● How to delay the onset of dialysis
  • 貧血
    • ● 貧血與診斷 - Anemia and Diagnosis
    • ● 貧血與治療 - Anemia and Treatment
    • ● 搶救貧血大作戰 - Fighting Anemia
    • ● 缺鐵性貧血與治療- Iron-Defici anemia
    • ● 貧血與慢性腎臟病- Anemia in CKD
    • ● 貧血可能的疾病風險
    • ● 輸血 相關知識- Blood Transfusion
    • ● Anemia and EPO Treatment
  • RA
    • ● 類風濕性關節炎 - Rheumatoid Arthritis
    • ● 類風濕性關節炎- Rheumatoid Arthritis
    • ● 過敏免疫風濕科- 常用藥物- A.I.R. Drug
    • ● 免疫調節藥- Methotrexate, MTX 至善錠
    • ● Methotrexate Toxicity- Treatment
    • ● 免疫調節藥- 磺胺藥- Sulfasalazine, SSZ
    • ● 免疫調節藥- Hydroxychloroquine, HCQ
    • ● 類固醇 藥物 - Steroids
    • ● 生物製劑 - Anti-TNF Biologic Agents
    • ● 生物製劑- 復邁 (Humira, Adalimumab)
    • ● 懷孕與類風濕關節炎藥物
    • ● C反應蛋白 C-Reactive Protein- CRP
    • ● 紅血球沉降率 - ESR
    • ● 類風濕因子 Rheumatoid Factor (RF)?
    • ● 抗環瓜氨酸抗體 - Anti-CCP
    • ● 食物療法與類風濕關節炎-Diet & RA
    • ● 食物與類風濕關節炎- Food & RA
    • ● Natural Remedies for RA
    • ● Vitamins, Minerals, and RA
  • 藥物
    • ● Acetylcysteine-富泌舒Fluimucil, Actein
    • ● 家庭常備藥物 - Family Kept Medicine
    • ● 小護士 - 曼秀雷敦 - Mentholatum
    • ● 乙醯胺酚-普拿疼止痛藥-Acetaminophen
    • ● 撒隆巴斯類 鎮痛貼片- Salonpas
    • ● 抗生素藥品 - Antibiotics
    • ● 麥格斯口服液- Megestrol Acetate
    • ● 萬靈藥 - 阿斯匹靈 - Aspirin
    • ● 藥物不良反應 - Adverse Drug Reaction
    • ● 葡萄柚汁可能對藥物的影響- Grapefruit
    • ● 藥物含鈉造成的不良作用
    • ● 瀉劑 - Bisacodyl
    • ● 毒物 戴奧辛 - Dioxin
    • ● Beware of the Prolia (injection) Drug.
    • ● 7 Drugs Whose Dangerous Risks
  • 藥物
    • ● 抗生素 賜復力生 Ceflexin - Cephalosporin
    • ● 抗生素 - Levofloxacin (Cravit)
    • ● 雙嘧達莫 - 潘生丁- Persantine
    • ● 諾安命 Novamin (Prochlorperazine)
    • ● 抗凝血劑- Warfarin 可邁丁- Coumadin
    • ● 高血壓藥- 脈優- Amlodipine- Norvasc
    • ● 高血壓藥 (道福寧) Dophilin
    • ● 類固醇 藥物 - Steroid Drugs
    • ● 消化性潰瘍藥 - Rabeprazole (Pariet)
    • ● 消化性潰瘍藥- Esomerprazole (Nexium)
    • ● 斷血炎 (Transamin) - 傳明酸
    • ● 除鐵能 - Deferoxamine (Desferal)
    • ● Pentoxifylline 與慢性腎臟病
    • ● 帕金森病用藥 Madopar 美道普
    • ● 帕金森病用藥 Requip 力必平(Ropinirole)
    • ●
  • 牙科
    • ● 正確的刷牙方式 - Teeth Brushing
    • ● 牙周病預防與治療-Periodontal disease
    • ● 牙結石清除-洗牙-Scaling & root planing
    • ● 牙痛的原因及應對方法 - Toothache
    • ● 經常刷牙保持口腔清潔,有助於預防失智症
    • ● 矯正牙齒時牙齦萎縮- Receding gum
    • ● 牙齦萎縮與牙齒病症- Gum Recession
    • ● 牙齒 根管治療術 - Root Canal
    • ● 牙齒顯微根管治療術- Microendodontics
    • ● 三叉神經痛誤以為牙痛,阿嬤沒牙才搞清楚
    • ● 婦人痛失五顆牙!才知三叉神經痛作怪
    • ● 資深牙醫的良心告白:能做假牙就不要植牙
    • ● 牙痛和三叉神經痛怎麼分辨?
    • ● 長期的不明原因的牙痛請注意牙隱裂
  • 教育
    • ●
    • ● 觀光餐飲成為台灣技職院校熱門科系
    • ● 台灣教育制度無助提升學生素質- Diploma
    • ● 台灣大學教育泡沫化- Busted education
    • ● 經濟搞成這樣很正常, 陸生: 文化大學弱爆了
    • ● 台灣大學數量密度過高, 大學學歷沒價值
  • 人物
    • ● 台灣 企業家 經營之神 王永慶
    • ● 台灣 企業家 宏達電 王雪紅 - Cher Wang
    • ● 台灣 企業家 鴻海 郭台銘 - Terry Gou
    • ● 中華民國 總統 馬英九 - Ma Ying-jeou
    • ● 台灣 第一名模 - 林志玲 - Lin Chi-Ling
    • ● 台灣特有的檳榔西施- Betel nut beauty
    • ● 台灣新聞人物相片- Taiwan image
    • ● 台灣 政治人物 婚外情
    • ● 台灣 陳水扁的319事件
  • 休閒
    • ▼ 電影 ===> >
      • ● 台北 電影院 Taipei Movie Theaters
      • ● 台灣國語電影- 經典回顧- Movie Classic
      • ● 台灣電影歷史介紹- Taiwan Movie History
      • ● 2011台灣電影〈賽德克·巴萊〉
      • ● 近年台灣電影 介紹
      • ★ 外國(電影) 記錄影片
    • ▼ 交通 ===> >
      • ● 台北 捷運系統 - Metro Taipei
      • ● 台灣 高速鐵路 - Taiwan HSR
      • ● 台灣 中華航空 - China Airlines
      • ● 台灣 長榮航空 - EVA Air
      • ● 台灣 計程車 - Taiwan Taxi
      • ● 台灣 遊覽車 - Taiwan Tour Bus
    • ● 台灣重要傳統節日- Taiwan festivals
    • ● 台灣廟會鋼管舞表演-Taiwan pole dance
    • ● 中秋節在台灣如何變成烤肉節
    • ● 台灣趣事笑話 集錦
    • ● 郊外美景欣賞 -
    • ● 環球小姐 選美 - Miss Universe
    • ● 好萊塢 健美男星- Hollywood Fit Stars
    • ● 2012台北世貿 新車大展-2012 Auto Show
    • ● 世界服裝展台走秀-Runway fashion show
    • ● 服裝設計展覽 - Fashion Design
    • ● 台北服裝走秀 - Fashion Show Taipei
    • ● 台北世貿中心- 資訊月 展覽
    • ● 台灣展場 Show Girls
    • ▼ 旅遊 ===>
  • 連接
    • 聯絡
    • ● 台灣美食悠遊網- Taiwan Gourmet
    • ● 台灣 旅遊網- Taiwan Tour Travel
    • ● 生活 智慧網- Good Living Website
    • ● 消費者 網站- Consumer Website
    • ★ 大陸 神州網- China Tour Travel
    • ● 台灣客 資訊網
    • ★ 知識 技術網
    • ● 快樂果 旅遊- Caolgo Tour & Travel
    • ● 自行車 全聯網 -(1)
    • ● 英文 學習網 (1)
    • ★ 最新天星英漢百科醫學辭典
    • ★ 醫學藥知網 - Medical Knowledge

現在位置 : 醫療 > 心臟病 > 心臟病 體外反搏治療 - EECP Therapy

心臟病 EECP體外反搏治療
狹心症及心臟衰竭的另類治療方式- 簡介EECP體外反搏治療 -
文/臺北醫學大學‧附設醫院/心臟內科施俊明主任/第162期/102年9月
       心臟疾病治療方式日新月異,這些年在醫療上的新方法─EECP(體外反搏療法),以壓力褲配合下肢擠壓,可以改善心肌功能,成為狹心症、心臟衰竭較安全而另類的治療方式。
        心臟醫學進展一直非常迅速,特別是在冠心症、心臟衰竭方面的治療。除了各種藥物發展,更有心導管及血管支架的治療、心臟同步節律器及體內電擊器等發展,外科手術也有長足進步。即使如此,仍有許多做完血管支架或外科繞道手術後,依舊胸悶或喘的病人;過去只能不斷加藥治療,但這些年EECP(Enhanced external counterpulsation)的治療逐漸成熟、療效也獲證實,被廣泛接受作為狹心症及心臟衰竭的替代或另類治療。北醫附設醫院也在去年底引進EECP的服務,頗獲病人好評。
       EECP (Enhanced External CounterPulsation)的概念已發展近半世紀,是一種非侵入性的機械輔助循環裝置,以壓力褲配合心跳做下肢擠壓,靠機械作用提高主動脈舒張壓,減低主動脈收縮壓,使心臟冠脈血流量增加,進而改善心肌代謝與功能。長時間EECP治療,能增加心臟的血管新生,進一步改善心肌功能。
        近年已有多項研究証實EECP具有增加冠狀動脈血流,提高血流切應力、改善血管內皮細胞結構及功能、防止血栓形成以及促進血管側枝循環形成等優點。有研究指出,臨床上病人對此治療的反應率可可達到70~80%,效果可能可持續長達2-5年之久。因此,目前醫界認為EECP對心絞痛及心臟衰竭病人來說,是一種有效且安全的另類治療選擇。
治療方式
       EECP治療時,病患舒服地躺在特製的床上,下肢、臀部裹以特製的氣囊套,以心電圖R波為觸發信號;在心臟舒張早期,氣囊由遠至近依序加壓,驅動下肢血液向主動脈返流,提高主動脈舒張壓,從而改善心臟、大腦等重要器官的血液供應。在心臟收縮期前,氣囊迅速排氣,受壓的肢體血管開放,使主動脈收縮壓下降,從而減少外週循環阻力,減輕心臟負荷。
       目前建議之治療療程為每次1小時, 一週5次, 持續7 週, 共35次。

治療範圍
       EECP能明顯地增加心臟及全身各臟器血液的灌注、提升血液供應量,改善缺血的情形;且在壓力的作用下,血液流速增加,降低了血液的粘稠度,抑制動脈粥樣硬化動脈粥樣硬化等病變的發生。主要應用在缺血性疾病,包括:冠心病、心絞痛、心肌缺血、陳舊性心肌梗塞、心肌炎後遺症、腦動脈硬化、腦供血不足、椎基底動脈供血不足,缺血性腎臟病。無法開刀、體內有導管等心臟病人,或是具糖尿病等心血管疾病、小血管疾病的病人,都適合使用EECP治療。
        但是嚴重主動脈瓣膜疾病、嚴重血壓控制不佳、嚴重下肢靜脈血栓等病人,不適宜接受EECP治療。

結語
       EECP提供患者一項非侵襲性的治療方式,無論短期、長期來看都有顯著療效,而且相關療程可在門診直接安排,省去病人反覆住院的不便及醫療支出。目前美國心臟學會(AHA)及歐洲心臟學會(ESC)在心血管疾病和心臟衰竭的相關治療指引中,已建議在符合相關適應症的患者身上使用EECP。因此對藥物反應不佳、無法接受侵入性治療的病人,可與心臟科醫師討論這項治療。但若要治本,藥物的使用、戒菸、運動等相關生活努力,仍是重要的養生之道。
Picture
目前建議之EECP治療療程為每次1小時, 一週5次, 持續7 週, 共35次。
Picture
Schematic mechanism of EECP - 目前建議之EECP治療療程為每次1小時, 一週5次, 持續7 週, 共35次。
External Counterpulsation Therapy (ECP)
       External counterpulsation therapy (ECP) is a procedure performed on individuals with angina or heart failure or cardiomyopathy in order to diminish symptoms of ischemia, improve functional capacity and quality of life. In various studies, ECP has been shown to relieve angina, and decrease the degree of ischemia in a cardiac stress test.
Method
       While an individual is undergoing ECP, he/she has pneumatic cuffs on his or her legs and is connected to telemetry monitors that monitor heart rate and rhythm. The most common type in use involves three cuffs placed on each leg (on the calves, the lower thighs, and the upper thighs (or buttock)). The cuffs are timed to inflate and deflate based on the individual's electrocardiogram. The cuffs should ideally inflate at the beginning of diastole and deflate at the beginning of systole. During the inflation portion of the cycle, the calf cuffs inflate first, then the lower thigh cuffs and finally the upper thigh cuffs. Inflation is controlled by a pressure monitor, and the cuffs are inflated to about 200 mmHg.
        When timed correctly, this will decrease the afterload that the heart has to pump against, and increase the preload that fills the heart, increasing the cardiac output. In this way, ECP is similar to the intra-aortic balloon pump (IABP). Since it increases pressure in the aorta while the heart is relaxing (during diastole) ECP also increases blood flow into the coronary arteries, which also occurs during that phase.
Physiological considerations
        One theory is that ECP exposes the coronary circulation to increased shear stress, and that this results in the production of a cascade of growth factors that result in angiogenesis. ECP is a rehabilitation process that provides mechanical external cardiac assistance on a consistent regimen resulting in significant improvement in energy and exercise tolerance much like an exercise program. By restoring oxygenated blood flow, there are abundant benefits to the body. This restoration of nutrient rich blood flow revives tissue in parts of the heart and body that have become 'stunned' or 'hibernated' due to restricted or blocked blood flow. The heart benefits greatly as patients will see an improvement in structure, strength (contracility) and a reduction in afterload (workload) due to the reduction in systemic vascular resistance. Patients will see improvements in symptoms of chest pain, shortness of breath, chronic fatigue (tiredness) as well as a significant improvement in exercise tolerance (energy).
Indications and Contraindications
       Indications: Angina patients who are not relieved by medicine. Patients who don’t want to have bypass surgery. Patients who are contraindicated for bypass or angioplasty like kidney failure, liver failure, severe COPD cases, Diffuse diabetes disease, very old age, patients of Syndrome X, i.e microvessel disease, ischaemic and dilated cardiomyopathy patients all can go for ECP.
       Contraindications: Severe aortic regurgitation and aortic stenosis Deep vein thrombosis Pregnancy Very high blood pressure Severe peripheral vascular disease.
Picture
Illustration depicting Cardiac External Counterpulsation (EECP)
Enhanced External counterpulsation (EECP)
      Enhanced External counterpulsation (EECP) is a unique FDA approved method doctors such as Dr. Steenblock use to treat circulatory conditions such as angina and a whole lot more. Known as “EECP” treatments are done using a computer-driven device in which three compressive air cuffs (like big blood pressure cuffs) are wrapped out a patient’s wrapped around each leg, one at calf level, another slightly above the knee and the third on the thigh. These are then inflated and deflated in synchronization with his or her cardiac or heart pumping cycle.  During diastole or when the heart fills with blood following a contraction the three sets of air cuffs are inflated in sequence (lower body to upper) which sends blood rushing to the heart. This causes an increase in diastolic blood pressure, the generation of arterial blood flow that is the reverse of what normally occurs and an increase in blood return from veins. The cuffs are all deflated just prior to contraction or systole, which (among other things) brings about a a decrease in ventricular workload and increased cardiac output.
       EECP has the near immediate effect of delivering more oxygen to the heart while simultaneously reducing the demand for oxygen by reducing the heart’s work requirements.  Over time it bolsters blood flow through blood vessels that feed the heart. Many doctors refer to this increased blood & oxygen flow as a “natural bypass.”
       Clinical studies have demonstrated that ECP/EECP reduces the number and severity of angina episodes. According to published data these effects stick around for months to years after a course of therapy is concluded. One review showed that EECP elicited a significant clinical response in 70-80% of treated patients with refractory angina which were sustained for up to 5 years.

Enhanced External Counterpulsation (EECP)
         There are a large, increasing number of patients who have persistent anginal symptoms, who have exhausted the standard treatments for revascularization and remain severely restricted. Enhanced External Counterpulsation (EECP) may stimulate the openings or formation of collaterals (small branches of blood vessels) to create a natural bypass around narrowed or blocked arteries.

Who is a candidate for EECP?
You may be a candidate if you:
Have chronic stable angina
Are not receiving adequate relief from angina by taking nitrates
Do not qualify as a candidate for invasive procedures (bypass surgery, angioplasty, or stenting)

What happens during EECP treatment?
EECP is a non-invasive, outpatient therapy. During treatment:
Patients lie down on a padded table in a treatment room
Three electrodes are applied to the skin of the chest and connected to an electrocardiograph (ECG) machine. The ECG will display the heart’s rhythm during treatment. Blood pressure is also monitored.
A set of cuffs is wrapped around the calves, thighs and buttocks. These cuffs attach to air hoses that connect to valves that inflate and deflate the cuffs. Patients experience a sensation of a strong "hug" moving upward from calves to thighs to buttocks during inflation followed by the rapid release of pressure on deflation. Inflation and deflation are electronically synchronized with the heartbeat and blood pressure using the ECG and blood pressure monitors.

How does EECP work?
       The EECP treatment gently but firmly compresses the blood vessels in the lower limbs to increase blood flow to your heart. Each wave of pressure is electronically timed to the heartbeat, so that the increased blood flow is delivered to your heart at the precise moment it is relaxing. When the heart pumps again, pressure is released instantaneously. This lowers resistance in the blood vessels in the legs so that blood may be pumped more easily from your heart.
       EECP may encourage blood vessels to open small channels that become extra branches. These channels or collaterals may eventually become "natural bypass" vessels to provide blood flow to heart muscle. This contributes to the relief of angina symptoms.

How often are patients treated?
Patients who are accepted for treatment must undergo 35 hours of EECP therapy. Treatment is administered 1-2 hours a day, five days a week, for 7 weeks.
       Published studies conducted at numerous medical centers have demonstrated benefits for most patients including:
Less need for anti-anginal medication
Decrease in symptoms of angina
Increased ability to do activities without onset of symptoms
Ability to return to enjoyable activities

Resources:
Coronary Artery Disease
Coronary Artery Disease web chat transcripts
Center for Advanced Ischemic Heart Disease
EECP - Vasomedical Patient Information
Powered by Create your own unique website with customizable templates.