首页|心脏康复计划对小切口冠状动脉旁路移植术后快速康复作用的倾向性评分匹配研究

心脏康复计划对小切口冠状动脉旁路移植术后快速康复作用的倾向性评分匹配研究

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目的 研究心脏康复计划在全身麻醉下小切口冠状动脉旁路移植术患者早期康复中的作用.方法 回顾性纳入2015年1月—2020年1月于郑州大学第一附属医院接受全身麻醉下小切口冠状动脉旁路移植术患者,按是否接受康复计划分为康复计划组和对照组.按照最近邻匹配法进行1:1倾向性评分匹配,分析匹配后两组患者在康复计划开始6个月、12个月后的临床数据.主要观察指标为心肺功能测试的摄氧峰值(peak oxygen intake,VO2 peak)和随访期(20个月)三级医院心血管专科就诊患者数.结果 共纳入600例患者,其中康复计划组200例,男137例、女63例,年龄61.00(56.00,65.00)岁;对照组400例,男285例、女115例,年龄60.00(56.00,65.00)岁.匹配后,两组各纳入患者176例,两组患者基线资料差异均无统计学意义(P>0.05).心脏康复计划6个月及12个月后,康复计划组与对照组相比,VO2peak差异有统计学意义[6个月:1.96(1.59,2.38)L/min vs.1.72(1.38,2.12)L/min,P<0.001;12 个月:2.40(2.21,2.63)L/min vs.2.12(1.83,2.45)L/min,P<0.001].随访期内两组患者三级医院心血管专科就诊率差异有统计学意义(P=0.004).结论 心脏康复计划对全身麻醉下小切口冠状动脉旁路移植术早期康复有积极作用,可改善患者运动能力.
Effect of cardiac rehabilitation program on rapid recovery of patients undergoing minimally invasive incision coronary artery bypass grafting:A propensity score-matching study
Objective To investigate the role of cardiac rehabilitation program in the early recovery after minimally invasive incision coronary artery bypass grafting with general anesthesia.Methods A retrospective study was performed on the patients who underwent minimally invasive incision coronary artery bypass grafting from January 2015 to January 2020 with general anesthesia in our hospital.The patients were divided into a cardiac rehabilitation group and a control group.The clinical data of the patients were collected in 6 months and 12 months after the beginning of cardiac rehabilitation program and were analyzed by propensity score-matching analysis with a ratio of 1∶1.The main outcomes were the peak oxygen uptake(VO2 peak)of cardiopulmonary function test and the number of patients attending cardiovascular specialties in tertiary hospitals during the follow-up period(20 months).Results A total of 600 patients were enrolled,including 200 patients in the cardiac rehabilitation group[137 males and 63 females,aged 61.00(56.00,65.00)years]and 400 patients in the control group[285 males and 115 females,aged 60.00(56.00,65.00)years].After matching,176 patients were included in each group,and the basical clinical data of the pateints were comparable(P>0.05).The VO2 peak of the cardiac rehabilitation group after 6 months and 12 months of cardiac rehabilitation was significantly different from that of the control group[6 months:1.96(1.59,2.38)L/min vs.1.72(1.38,2.12)L/min,P<0.001;12 months:2.40(2.21,2.63)L/min vs.2.12(1.83,2.45)L/min,P<0.001].During the follow-up period,there was a statistical difference in the cardiovascular specialist visits in tertiary hospitals(P=0.004).Conclusion Cardiac rehabilitation program has a positive effect on the recovery of minimally invasive incision coronary artery bypass grafting with general anesthesia,and can improve the exercise ability of patients.

Cardiac rehabilitationminimally invasive incisioncoronary artery bypass graftingenhanced recovery after surgery

李帆、郭元婷、周小宇、梁振兴

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郑州大学第一附属医院麻醉与围术期医学部(郑州 450052)

郑州大学第一附属医院心脏大血管外三科(郑州 450052)

上海交通大学附属胸科医院心外科(上海 200030)

心脏康复 小切口 冠状动脉旁路移植术 加速康复

国家自然科学基金

81700236

2024

中国胸心血管外科临床杂志
四川大学华西医院

中国胸心血管外科临床杂志

CSTPCD北大核心
影响因子:0.846
ISSN:1007-4848
年,卷(期):2024.31(3)
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