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延迟独立行走和萨科佩尼亚进展的恢复对内血管大动脉动脉瘤修复后的长期结果的影响
Hirokazu Sugiura1,2, Tsuyoshi Shibata2, Yutaka Iba2
1Department of Rehabilitation, Sapporo City General Hospital, Sapporo, Japan.
Geriatrics & gerontology international
|January 22, 2026
概括
在血管内大动脉动脉瘤修复 (EVAR) 后,步行能力的延迟恢复和恶化的缩症独立预测死亡率. 这些因素可以帮助识别高风险患者进行有针对性的康复.
科学领域:
- 血管外科 血管外科
- 老年学是一门学科.
- 康复医学 康复医学 康复医学
背景情况:
- 内血管大动脉动脉瘤修复 (EVAR) 是腹腔大动脉动脉瘤的常见手术.
- 评估EVAR后的长期结果需要了解超出即时手术成功的因素.
- 在老年患者中,独立行走和肌肉质量 (sarcopenia) 对于康复和生存至关重要.
研究的目的:
- 调查EVAR后延迟行走恢复的长期预后意义.
- 为了评估手术后肉症进展对EVAR后死亡率的影响.
- 为了确定潜在的临床指标风险分层在EVAR患者.
主要方法:
- 一项多中心回顾性队列研究包括228名接受EVAR的患者.
- 独立行走被定义为步行≥15米;在CT扫描上通过psoas肌肉指数 (PMI) 评估了肉症.
- 所有原因的死亡率是主要结果,使用Cox比例危险模型分析了平均4.6年的随访时间.
主要成果:
- 延迟行走 (≥2天) 和肉症进展 (PMI下降≥6.09%) 是死亡率的独立预测因素.
- 患有延迟行走和肉症进展的患者的生存率最差.
- 步行时间和PMI变化与EVAR后的全因死亡率有显著的相关性.
结论:
- 延迟的独立行走和手术后的肉症进展是EVAR后死亡率的显著独立预测因素.
- 这些发现表明,行走恢复和肉变化可以作为有价值的预后指标.
- 基于这些临床参数,可以制定风险分层和有针对性的康复策略.
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