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不同闭塞性病变的外周动脉疾病患者下肢搭桥手术后的康复进展

Rehabilitation progress after lower-extremity bypass surgery in patients with peripheral arterial disease with different occlusive lesions.

作者信息

Matsuo Tomohiro, Morimoto Yosuke, Otsuka Shota, Hojo Yu, Morisawa Tomoyuki, Ishida Atsuhisa

机构信息

Department of Rehabilitation, Nishi Memorial Port-island Rehabilitation Hospital: 8-5-2 Minatojimanakamachi, Chuo-ku, Kobe, Hyogo 650-0046, Japan.

Department of Physical Therapy, Faculty of Rehabilitation, Kobe Gakuin University, Japan.

出版信息

J Phys Ther Sci. 2021 Mar;33(3):261-266. doi: 10.1589/jpts.33.261. Epub 2021 Mar 17.

DOI:10.1589/jpts.33.261
PMID:33814714
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8012193/
Abstract

[Purpose] To examine the differences in rehabilitation progress after lower-extremity bypass surgery for peripheral arterial disease (PAD) depending on the occlusive lesions. [Participants and Methods] This was a retrospective study. We included 50 patients (61 limbs; 38 males and 12 females; mean age, 73 years) who underwent lower-extremity bypass surgery for Fontaine stage 2-3 PAD. The patients were assigned to the aortoiliac (A-I) group (n=23), femoropopliteal (F-P) group (n=18), and below-knee group (n=9). We evaluated the postoperative rehabilitation progress and length of hospital stay of these groups. [Results] The postoperative ankle-brachial pressure index (ABI) of the A-I group was significantly lower than that of the F-P group, although there were no differences before surgery. The progress of rehabilitation and the length of hospitalization showed no significant differences among the three groups. The postoperative date of independent walking was significantly later in the presence of complications than in the absence of complications. [Conclusion] The progress of rehabilitation after lower-extremity bypass surgery did not differ depending on the occlusive lesions, and patients may acquire independent walking ability in approximately 5 days in the absence of postoperative complications.

摘要

[目的] 根据闭塞性病变,研究下肢旁路手术治疗外周动脉疾病(PAD)后康复进程的差异。[参与者与方法] 这是一项回顾性研究。我们纳入了50例接受Fontaine 2-3期PAD下肢旁路手术的患者(61条肢体;男性38例,女性12例;平均年龄73岁)。患者被分为主髂动脉(A-I)组(n = 23)、股腘动脉(F-P)组(n = 18)和膝下组(n = 9)。我们评估了这些组的术后康复进程和住院时间。[结果] A-I组术后踝肱压力指数(ABI)显著低于F-P组,尽管术前无差异。三组之间的康复进程和住院时间无显著差异。有并发症时术后独立行走日期显著晚于无并发症时。[结论] 下肢旁路手术后的康复进程不因闭塞性病变而异,且在无术后并发症的情况下,患者大约可在5天内获得独立行走能力。

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本文引用的文献

1
Lower Extremity Bypass Surgery on Patients Transferred from Other Hospitals is Associated with Increased Morbidity and Mortality.从其他医院转来的患者进行下肢搭桥手术与发病率和死亡率增加相关。
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Characteristics of physical activity in patients with critical limb ischemia.严重肢体缺血患者的身体活动特征
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3
2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.2016年美国心脏协会/美国心脏病学会下肢外周动脉疾病患者管理指南:执行摘要:美国心脏病学会/美国心脏协会临床实践指南工作组报告
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4
Clinical importance of change in physical activity after endovascular treatment combined with exercise training in patients with peripheral arterial disease.血管内治疗联合运动训练后外周动脉疾病患者身体活动变化的临床重要性。
Heart Vessels. 2017 Feb;32(2):143-148. doi: 10.1007/s00380-016-0856-4. Epub 2016 Jun 1.
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Effect of in-hospital physical activity on cardiovascular prognosis in lower extremity bypass for claudication.住院期间身体活动对下肢搭桥治疗间歇性跛行心血管预后的影响。
J Phys Ther Sci. 2015 Jun;27(6):1855-9. doi: 10.1589/jpts.27.1855. Epub 2015 Jun 30.
6
Strategies for managing aortoiliac occlusions: access, treatment and outcomes.腹主动脉髂动脉闭塞的管理策略:入路、治疗及结果
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A systematic review of treatment of intermittent claudication in the lower extremities.下肢间歇性跛行治疗的系统评价
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8
Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: management of asymptomatic disease and claudication.血管外科学会下肢动脉粥样硬化闭塞性疾病实践指南:无症状疾病和间歇性跛行的管理
J Vasc Surg. 2015 Mar;61(3 Suppl):2S-41S. doi: 10.1016/j.jvs.2014.12.009. Epub 2015 Jan 28.
9
Guidelines for rehabilitation in patients with cardiovascular disease (JCS 2012).心血管疾病患者康复指南(2012年日本循环学会指南)
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A meta-analysis of endovascular versus surgical reconstruction of femoropopliteal arterial disease.股腘动脉病变腔内治疗与手术重建的荟萃分析
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