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在腹部手术后恢复正常活动:七个低收入和中等收入国家的随机对照试验的预先计划的二次分析

Omar Omar¹, Sivesh Kathir Kamarajah²

¹NIHR Global Health Research Unit on Global Surgery, Institute of Applied Health Research, University of Birmingham, Birmingham, UK.

|August 29, 2025

概括

低收入和中等收入国家 (LMICs) 的大多数患者在进行重大腹部手术后会康复,但癌症和中线切口等因素会影响恢复正常活动. 有针对性的康复可以改善复苏并减少经济损失.

科学领域:

全球手术
健康成果研究
手术恢复

背景情况:

在低收入和中等收入国家 (LMICs) 中,由于手术疾病负担的增加,重大手术的恢复至关重要.
在LMIC环境中,关于手术后恢复正常活动的数据有限.
患者的康复对社会和经济福利产生重大影响.

研究的目的:

在LMIC中描述重大腹部手术后恢复正常活动的模式.
确定这些人群中延迟恢复的因素.

主要方法:

一个集群随机试验的分析,涉及7个LMIC的81个中心的12,340名患者.
主要结局:在手术后30天,自我报告的完全恢复正常活动.
贝叶斯混合效应逻辑回归用于探索相关因素,对缺失数据进行敏感性分析.

主要成果:

在手术后30天,65. 3%的患者恢复正常活动.
良性与癌症手术 (67. 0%与59. 7%),轻微手术与重大手术 (71. 0%与63. 5%) 和非中线与中线切口 (74. 9%与58. 7%) 的恢复率较高.
调整后的分析证实良性手术 (OR: 0. 61),轻微手术 (OR: 0. 56) 和非中线手术 (OR: 1.57) 是重要的因素.

结论:

在LMIC中确定需要改善术后恢复支持的患者群体.
建议加强与世卫组织指导方针一致的康复途径.
建议改善恢复可以增强患者的财务风险保护并减少经济生产力损失.

关键词:

腹部手术恢复正常活动恢复工作

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