应用快速康复理念优化心脏介入围术期流程对桡动脉支架植入术后患者康复影响的随机对照试验
|
摘要
目的探究应用快速康复外科(fast-track surgery,FTS)理念优化心脏介入围术期流程对桡动脉支架植入术后患者康复的影响。方法将2017年6月至2018年5月于我科行桡动脉支架植入术的患者采用随机数字表法分为对照组及FTS组,每组各95例。其中对照组,男60例、女35例,年龄35～88(65.2±9.6)岁;FTS组,男62例、女33例,年龄34～86(61.5±11.3)岁。对照组实施围术期常规处理措施,FTS组运用快速康复理念进行流程优化干预,对患者入院前、住院期间及出院后疾病康复进行针对性的个体化管理,比较分析两组的住院时间、患者满意度、术后并发症、疾病自我管理能力及再住院率。结果与对照组比较,FTS组患者住院时间明显缩短,术后并发症降低,住院满意度增加,患者对疾病的自我管理能力提高,再住院率降低,两组差异有统计学意义(P<0.05)。结论 FTS理念应用于心脏介入对围术期进行流程优化,可有效降低术后患者并发症发生率,提高自我管理能力,缩短住院时间,有效避免心脏不良事件的发生,有利于患者的心脏康复。
Objective To explore the influence of applying the fast-track surgery(FTS) to optimize the process in the perioperative period of cardiac intervention on the rehabilitation of patients with radial artery stenting surgery.Methods A total of 190 patients with radial artery stenting surgery in the Department of Cardiology, West China Hospital from June 2017 to May 2018 were enrolled. They were randomized into a control group(n=95) and a FTS group(n=95) by random umber table. There were 60 males and 35 females aged 35-88(65.2±9.6) years in the control group as well as 62 males and 33 females aged 34-86(61.5±11.3) years in the FTS group. Patients in the control group received routine perioperative care, but patients in the FTS group received individual precision interventions by applying the FTS concept to optimize the process of perioperative care, including individual care management before being admitted into hospital, during hospital, and after discharge from hospital. Duration of hospital stay, satisfaction scores, number of comorbidities after surgery, disease self-management ability, and readmission rates were compared between the two groups. Results Compared to the control group, the FTS group had significantly shorter duration of hospital stay, less comorbidities, higher satisfaction scores and disease self-management ability, and lower readmission rate to hospital(P<0.05). Conclusion Applying FTS into the perioperative period of cardiac interventions to optimize its process can help patients recover from radial artery stenting surgery, increase patients' self-management abilities, shorten duration of hospital stay and decrease comorbidities and cardiac adverse events.
Objective To explore the influence of applying the fast-track surgery(FTS) to optimize the process in the perioperative period of cardiac intervention on the rehabilitation of patients with radial artery stenting surgery.Methods A total of 190 patients with radial artery stenting surgery in the Department of Cardiology, West China Hospital from June 2017 to May 2018 were enrolled. They were randomized into a control group(n=95) and a FTS group(n=95) by random umber table. There were 60 males and 35 females aged 35-88(65.2±9.6) years in the control group as well as 62 males and 33 females aged 34-86(61.5±11.3) years in the FTS group. Patients in the control group received routine perioperative care, but patients in the FTS group received individual precision interventions by applying the FTS concept to optimize the process of perioperative care, including individual care management before being admitted into hospital, during hospital, and after discharge from hospital. Duration of hospital stay, satisfaction scores, number of comorbidities after surgery, disease self-management ability, and readmission rates were compared between the two groups. Results Compared to the control group, the FTS group had significantly shorter duration of hospital stay, less comorbidities, higher satisfaction scores and disease self-management ability, and lower readmission rate to hospital(P<0.05). Conclusion Applying FTS into the perioperative period of cardiac interventions to optimize its process can help patients recover from radial artery stenting surgery, increase patients' self-management abilities, shorten duration of hospital stay and decrease comorbidities and cardiac adverse events.
引文
1Wilmore DW, Kehlet H. Management of patients in fast track surgery. BMJ, 2001, 322(7284):473-476.
2Kehlet H, Wilmore DW. Multimodal strategies to improve surgical outcome. Am J Surg, 2002, 183(6):630-641.
3Ren L, Zhu D, Wei Y, et al. Enhanced Recovery After Surgery(ERAS)program attenuates stress and accelerates recovery in patients after radical resection for colorectal cancer:a prospective randomized controlled trial. World J Surg, 2012, 36(2):407-414.
4Ahmed J, Khan S, Lim M, et al. Enhanced recovery after surgery protocols-compliance and variations in practice during routine colorectal surgery. Colorectal Dis, 2012, 14(9):1045-1051.
5Ulici A, Dulea AM, Tevanov I, et al. Total hip replacement in congenital hip dislocation in 14 years female patient. Chirurgia(Bucur), 2016, 111(3):279-282.
6袁敏,张文君.快速康复外科理念在全髋关节置换围手术期管理中的应用.护理实践与研究, 2013, 10(7):24-26.
7Guen ML, Cholley B, Fischler M. New fast-track concepts in thoracic surgery:anesthetic implications. Curr Anesthesiol Rep,2016, 6(2):117-124.
8国际心脏病学会和协会WHO命名标准化联合专题组.缺血性心脏病命名及诊断标准.中华心血管杂志, 1981, 9(11):75-76.
9Schatz C. Enhanced recovery in a minimally invasive thoracic surgery program. AORN J, 2015, 102(5):482-492.
10刘小春.快速康复理念在体外循环心脏患者围术期护理中的应.护士进修杂志, 2011, 26(13):1198-1201.
11尤振兵,徐达夫,嵇建.快速康复外科理念在食管癌治疗中的应.中华胃肠外科杂志, 2012, 15(6):561-563.
12石晶,郑剑爽.快速康复外科理念在心脏外科手术护理中的应用.中国实用医药, 2015, 10(34):225-226.
13车国卫,李为民,刘伦旭.快速肺康复需要围手术期流程优化.中国胸心血管外科临床杂志, 2016, 23(3):216-220.
2Kehlet H, Wilmore DW. Multimodal strategies to improve surgical outcome. Am J Surg, 2002, 183(6):630-641.
3Ren L, Zhu D, Wei Y, et al. Enhanced Recovery After Surgery(ERAS)program attenuates stress and accelerates recovery in patients after radical resection for colorectal cancer:a prospective randomized controlled trial. World J Surg, 2012, 36(2):407-414.
4Ahmed J, Khan S, Lim M, et al. Enhanced recovery after surgery protocols-compliance and variations in practice during routine colorectal surgery. Colorectal Dis, 2012, 14(9):1045-1051.
5Ulici A, Dulea AM, Tevanov I, et al. Total hip replacement in congenital hip dislocation in 14 years female patient. Chirurgia(Bucur), 2016, 111(3):279-282.
6袁敏,张文君.快速康复外科理念在全髋关节置换围手术期管理中的应用.护理实践与研究, 2013, 10(7):24-26.
7Guen ML, Cholley B, Fischler M. New fast-track concepts in thoracic surgery:anesthetic implications. Curr Anesthesiol Rep,2016, 6(2):117-124.
8国际心脏病学会和协会WHO命名标准化联合专题组.缺血性心脏病命名及诊断标准.中华心血管杂志, 1981, 9(11):75-76.
9Schatz C. Enhanced recovery in a minimally invasive thoracic surgery program. AORN J, 2015, 102(5):482-492.
10刘小春.快速康复理念在体外循环心脏患者围术期护理中的应.护士进修杂志, 2011, 26(13):1198-1201.
11尤振兵,徐达夫,嵇建.快速康复外科理念在食管癌治疗中的应.中华胃肠外科杂志, 2012, 15(6):561-563.
12石晶,郑剑爽.快速康复外科理念在心脏外科手术护理中的应用.中国实用医药, 2015, 10(34):225-226.
13车国卫,李为民,刘伦旭.快速肺康复需要围手术期流程优化.中国胸心血管外科临床杂志, 2016, 23(3):216-220.