对接受冠状动脉手术的患者进行基于运动的心脏康复:基于当前随机对照试验的系统审查和元分析
Yan Shi1, Huiqing Xu2, Jige Dong1
1Rehabilitation Treatment Center of Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing, China.
International journal of surgery (London, England)
|February 4, 2025
概括
基于运动的心脏康复 (CR) 显著改善了冠状动脉手术后患者的健康相关生活质量 (HRQoL). 这种方法不会增加死亡率或并发症,提供安全有效的恢复选择.
科学领域:
- 心脏病学 心脏病学
- 康复医学 康复医学 康复医学
- 基于证据的实践.
背景情况:
- 基于运动的心脏康复 (CR) 越来越多地因其在冠心病 (CHD) 管理中的好处而得到认可.
- 接受冠状动脉旁路移植 (CABG) 和皮肤冠状动脉干预 (PCI) 的患者是CR的主要候选人.
研究的目的:
- 评估基于运动的CR对CABG和PCI后患者的影响.
- 评估CR对死亡率,并发症,住院和与健康相关的生活质量 (HRQoL) 的影响.
主要方法:
- 一个系统的审查和对25个随机对照试验 (RCTs) 的元分析,涉及4106名参与者.
- 搜索的主要数据库 (PubMed,Embase,Cochrane,Web of Science) 截至2023年12月.
- 主要结局:死亡率,并发症,住院,HRQoL. 使用审查经理5.2和Stata 12.0.0进行统计分析.
主要成果:
- 基于运动的CR并没有显著增加全因或心血管死亡率.
- 没有观察到CABG或PCI后冠状动脉并发症的显著增加.
- 显著降低了50%的心肌梗塞 (MI) 发生率和26%的全因住院病例.
- HRQoL显著改善,通过SF-36总结分数 (SMD:0.24) 和8个领域 (SMD:0.35) 进行评估.
结论:
- 基于运动的CR有效提高冠状动脉手术后患者的HRQoL.
- CR不会增加死亡率或需要重新干预.
- 这支持将基于运动的CR整合到术后心脏护理途径中.
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