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在手术中常规麻醉病房的患者访问:TRACE随机临床试验的1年结果

Valérie M Smit-Fun¹, Dianne de Korte-de Boer¹, Thomas Damen¹

¹Department of Anaesthesia and Pain Medicine, Maastricht University Medical Centre +, Maastricht, The Netherlands.

The British journal of surgery

|March 12, 2025

概括

在手术后一年,例行术后麻醉访问并没有改善患者的结果. 许多患者在日常活动和生活质量方面经历了持续的限制,这表明需要更好的术后护理策略.

科学领域:

麻醉学麻醉学
手术结果研究研究
患者的恢复患者的恢复

背景情况:

此前,TRACE随机对照试验 (RCT) 没有发现病房内术后麻醉诊所对外术期间有任何益处.
这项研究旨在评估这种干预措施对手术后长达一年的患者结果的长期影响.

研究的目的:

评估例行术后麻醉病房访问对1年临床结果的影响.
评估对接受选择性非心脏手术的患者功能恢复和生活质量的影响.

主要方法:

在荷兰九家医院,对来自TRACE RCT的5473名成年患者进行了长达一年的随访.
干预组在术后第一和第三天接受了例行麻醉检查.
结果措施包括1年死亡率,再入院,再手术,功能恢复 (GSR,ADL,FRI) 和生活质量 (EQ-5D-5L).

主要成果:

干预组和对照组在1年死亡率,再入院,重新手术,功能恢复或生活质量方面没有发现显著差异.
一年后,虽然功能恢复和生活质量恢复到基线水平,但30%的患者在日常生活活动中存在限制.
很大一部分 (40%-51%) 报告说,他们有持续的移动性问题,通常的活动,以及疼痛/不适.

结论:

常规的术后麻醉病房访问不会在非心脏手术后1年改善临床,功能或生活质量的结果.
相当数量的患者经历了持续的与健康有关的限制,影响了手术后一年的日常生活.
该研究强调,与十年前相比,1年死亡率没有改善,并表明在术后恢复和生活质量方面有很大的改善空间.

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