中国胸心血管外科临床杂志

中国胸心血管外科临床杂志

应用快速康复理念优化心脏介入围手术期流程对桡动脉支架植入术后患者康复的影响

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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手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 月于本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。对照组实施围手术期常规处理措施,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,再住院率有降低,以上各项数据的差异有统计学意义(P<0.05)。 结论 FTS 理念应用于心脏介入对围手术期进行流程优化,可有效降低术后患者并发症的发生,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 received radial artery stenting surgery. Methods A total of 190 participants received radial artery stenting surgery in West China Hospital Cardiology Department were randomized into control group (n=95) and FTS group (n=95). Participants in the control group received routine perioperative care, but participants 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. Five items including duration of staying in hospital, satisfaction scores, number of comorbidities after surgery, disease self-management ability, and readmission rates were compared between the control group and the FTS group, respectively. Results Compared to control group, FTS group had statistically significant shorter duration of stay in hospital, less comorbidities, higher satisfaction, higher disease self-management ability, and decreased 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, including increased patients’ self-management abilities, shorter duration of stay in hospital, fewer comorbidities and cardiac events.

关键词: 快速康复; 围手术期流程优化; 桡动脉穿刺; 支架植入术; 心脏康复

Key words: Fast-track surgery; perioperative process optimization; radial artery puncture; stent implantation; cardiac rehabilitation

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