Cardiac Surgical Research Unit, Alfred Hospital, Department of Surgery, Monash University, Baker IDI Institute Melbourne, Australia.
BMC Complement Altern Med. 2011 Mar 9;11:20. doi: 10.1186/1472-6882-11-20.
Preoperative anxiety and physical unfitness have been shown to have adverse effects on recovery from cardiac surgery. This study involving cardiac surgery patients was primarily aimed at assessing the feasibility of delivering physical conditioning and stress reduction programs within the public hospital setting. Secondary aims were to evaluate the effect of these programs on quality of life (QOL), rates of postoperative atrial fibrillation (AF) and length of stay (LOS) in hospital.
Elective patients scheduled for coronary artery bypass graft and/or valve surgery at a public hospital in Melbourne, Australia were enrolled. Patients were randomized to receive either holistic therapy (HT) or usual care (UC). HT consisted of a series of light physical exercise sessions together with a mental stress reduction program administered in an outpatient setting for the first two weeks after placement on the waiting list for surgery. A self-administered SF-36 questionnaire was used to measure QOL and hospital records to collect data on LOS and rate of postoperative AF.
The study population comprised 117 patients of whom 60 received HT and 57 received UC. Both programs were able to be delivered within the hospital setting but ongoing therapy beyond the two week duration of the program was not carried out due to long waiting periods and insufficient resources. HT, as delivered in this study, compared to UC did not result in significant changes in QOL, LOS or AF incidence.
Preoperative holistic therapy can be delivered in the hospital setting, although two weeks is insufficient to provide benefits beyond usual care on QOL, LOS or postoperative AF. Further research is now required to determine whether a similar program of longer duration, or targeted to high risk patients can provide measurable benefits.
This trial was conducted as part of a larger study and according to the principles contained in the CONSORT statement 2001.
术前焦虑和身体不适已被证明会对心脏手术后的恢复产生不利影响。这项涉及心脏手术患者的研究主要旨在评估在公立医院环境中提供身体调理和减轻压力计划的可行性。次要目标是评估这些计划对生活质量（QOL）、术后心房颤动（AF）发生率和住院时间（LOS）的影响。
在澳大利亚墨尔本的一家公立医院接受冠状动脉旁路移植术和/或瓣膜手术的择期患者被纳入研究。患者被随机分配接受整体治疗（HT）或常规护理（UC）。HT 包括一系列轻度体育锻炼课程，以及在手术等待名单上的前两周内，在门诊环境中进行的精神压力减轻计划。使用自我管理的 SF-36 问卷来衡量 QOL，医院记录来收集 LOS 和术后 AF 发生率的数据。
研究人群包括 117 名患者，其中 60 名接受 HT，57 名接受 UC。两个方案都能够在医院环境中实施，但由于等待时间长和资源不足，无法进行计划外的持续治疗。与 UC 相比，HT 在本研究中没有导致 QOL、LOS 或 AF 发生率的显著变化。
术前整体治疗可以在医院环境中实施，尽管两周时间不足以提供比常规护理更好的 QOL、LOS 或术后 AF 益处。现在需要进一步研究，以确定是否可以提供更长时间的类似计划，或针对高危患者的计划，可以提供可衡量的益处。
本试验是作为一项更大研究的一部分进行的，并根据 CONSORT 声明 2001 中的原则进行。
