在主要的手术瘤学中,一个结构化的基于风险的预康复计划的工具箱
Svenja Sliwinski1, Elisabeth Werneburg1, Sara Fatima Faqar-Uz-Zaman1
1Department of General, Visceral, Transplant and Thoracic Surgery, University Hospital Frankfurt, Goethe University Frankfurt/Main, Frankfurt/Main, Germany.
Frontiers in surgery
|July 12, 2023
概括
预康复可以通过运动,营养和心理健康支持,提高患者在手术前的性. 本范围审查概述了制定标准化临床预康复方案和改善手术结果的关键方面.
科学领域:
- 在外科手术期间的医学.
- 基于证据的实践.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 预康复是一种多模式的方法,用于增强患者在手术前的性,包括身体,营养和心理社会因素.
- 关于预康复结果和定义的现有文献是异质的,需要进行结构化审查.
研究的目的:
- 对1类和2类证据进行范围审查,以确定治疗途径中预康复的关键方面.
- 为制定系统方法和临床标准提供建议.
主要方法:
- 包括1类和2类证据,以确定预康复的七个主要方面.
- 分析风险评估工具,运动原则 (FITT),结果措施,营养,患者血液管理,心理健康和经济潜力.
主要成果:
- 建议的风险评估工具包括风险分析指数,查尔森并发症指数 (CCI),ASA评分和ECOG.
- 最佳的炼方案包括3-6周的3-4次/周 (30-60分钟) 的呼吸练习和中高强度的间隔.
- 6分钟步行测试适用于评估有氧能力,而长期结果包括生存率和病率降低 (高达50%).
结论:
- 预康复提供了显著的潜力,以减少发病率和改善患者的结果,有利的成本-收益评估.
- 标准化,验证的工具和反复评估对于有效的预康复至关重要.
- 这些建议构成了制定强有力的临床预康复标准的工具箱.
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