一个可访问的预康复包,为患者接受选择性心脏门手术的有限资源:时代随机临床试验
Zeruxin Luo1, Xiu Zhang1, Yuqiang Wang2
1Department of Rehabilitation Medicine, West China Hospital, Sichuan University, 610041 Chengdu, Sichuan, China.
Reviews in cardiovascular medicine
|July 30, 2024
概括
一个为期3天的预康复包显著降低了手术后肺部并发症 (PPC) 和心脏门手术患者的成本. 这种可访问的干预为资源有限的环境提供了一个可行的模型.
科学领域:
- 心脏病学 心脏病学
- 肺部医学 肺部医学
- 康复医学 康复医学 康复医学
背景情况:
- 在心脏门外科手术中,预康复未得到充分利用,特别是在发展中国家.
- 资源有限阻碍了手术前运动和教育计划的实施.
- 越来越多的证据支持预康复的好处,需要可访问的干预模型.
研究的目的:
- 评估选择性心脏门手术患者新型3天预康复计划的可行性和有效性.
- 确定干预对术后肺部并发症 (PPC) 的影响.
- 评估二次结果,包括干预可行性,呼吸机使用,住院和相关医疗费用.
主要方法:
- 一个单中心,评估者盲目的随机临床试验,涉及165名患者.
- 患者被随机分配到常规护理或常规护理加上3天的康复前包 (TIME:鼓舞性肌肉训练,有氧肌肉训练和教育).
- 主要结果是PPC的发生率;次要结果包括可行性,停留时间和成本.
主要成果:
- 时间组显示PPC的发生率明显较低 (OR,0.60;p=0.006).
- 康复前包是可行的,耐受良好,并与高患者满意度相关.
- 与对照组相比,TIME组的PPC相关医疗费用较低 (p < 0.001).
结论:
- 一个为期3天的预康复套餐有效地减少了PPC,住院和选择性心脏门手术的成本.
- 这种干预提供了一个可访问和潜在的可扩展的预康复模型,特别是在资源有限的地区.
- 时代计划展示了显著的临床和经济效益,倡导其更广泛的采用.
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