多模式预康复对肺癌手术术术后后果的影响
Ah-Reum Cho1, Tahereh Najafi2, Agnihotram V Ramanakumar2
1Department of Anesthesia, Montreal General Hospital, McGill University Health Centre, Montreal, Quebec, Canada; Department of Anesthesia and Pain Medicine, School of Medicine, Medical Research Institute, Pusan National University, Yangsan, Republic of Korea.
The Journal of thoracic and cardiovascular surgery
|March 5, 2025
概括
多模式预康复显著减少了肺癌手术患者的术后并发症. 这种方法通过降低并发症率和严重程度来改善结果,有利于脆弱,老年人和高危人群.
科学领域:
- 胸部外科手术 胸部外科手术
- 在瘤学瘤学.
- 老年病的医生 老年病的医生
背景情况:
- 肺癌患者通常是老年人,虚弱,吸烟者,功能储备较差.
- 这些因素增加了手术风险,使他们成为预康复的理想候选人.
- 被转移到预康复诊所的患者甚至有更高的外科手术风险.
研究的目的:
- 为了比较肺癌手术患者的30天术后结果,这些患者接受了多模式预康复治疗,而不是那些没有接受多模式预康复治疗的患者.
- 评估预康复对并发症发生率和严重程度的影响.
主要方法:
- 肺癌手术患者的回顾性观察研究 (2018年8月 - 2024年1月).
- 根据关键基线特征 (呼吸系统疾病,预测的LOS,DASI<34,瘤阶段,新辅助疗法) 进行1:1的倾向得分匹配.
- 在匹配组之间比较基线,术前,术后和术后的结果.
主要成果:
- 在1242名患者中选择了555名后,分析了147对匹配的对.
- 预康复组的整体并发症 (46.3%vs65.3%) 和重大并发症 (13.6%vs27.9%) 显著降低.
- 预康复患者的综合并发症指数较低 (0-20.9 vs 0-26.2),ICU入院减少 (2.7% vs 8.2%),再入院率较低 (6.1% vs 14.3%).
结论:
- 多模式预康复显著减少了肺癌手术中的30天术后并发症.
- 预康复还可以降低并发症的严重程度,并改善其他关键结果.
- 这种方法有望改善高风险肺癌患者的术后结果.
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