School of Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK; University Hospital Southampton NHS Foundation Trust, Southampton, UK; NIHR Biomedical Research Centre, Southampton, University Hospital Southampton NHS Foundation Trust, UK; Anaesthesia, Perioperative and Critical Care Research Group, NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust/University of Southampton, Southampton, UK; Department of Anesthesiology, Duke University School of Medicine, Durham, NC, USA; Duke Clinical Research Institute, Durham, NC, USA.
University Hospital Southampton NHS Foundation Trust, Southampton, UK; NIHR Biomedical Research Centre, Southampton, University Hospital Southampton NHS Foundation Trust, UK; Anaesthesia, Perioperative and Critical Care Research Group, NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust/University of Southampton, Southampton, UK; Department of Anesthesiology, Duke University School of Medicine, Durham, NC, USA; Duke Clinical Research Institute, Durham, NC, USA.
Best Pract Res Clin Anaesthesiol. 2021 Dec;35(4):507-516. doi: 10.1016/j.bpa.2021.01.001. Epub 2021 Jan 27.
To evaluate the role of prehabilitation interventions in adult patients before elective major surgery.
Exercise training before elective adult major surgery is feasible and safe. Efficacy has been determined but the clinical effectiveness remains uncertain. Early data suggest a reduction in morbidity, length of stay, and an improvement in the quality of life. Nutritional and psychological interventions are less well evaluated, and when they are, it is often in combination with exercise interventions as part of multimodal prehabilitation.
Studies evaluating multimodal prehabilitation interventions before elective major surgery in adults are producing encouraging early results, but definitive clinical effectiveness is currently very limited. Future research should focus on refining interventions, exploring mechanisms, establishing minimum dosage, interrogating interactions between therapies, and urgent implementation of large-scale clinical effectiveness studies.
评估术前成人患者的康复干预措施的作用。
在择期成人大型手术前进行运动训练是可行且安全的。已确定其疗效，但临床效果仍不确定。早期数据表明发病率、住院时间减少，生活质量提高。营养和心理干预措施的评估较少，而且当评估这些措施时，通常与运动干预相结合，作为多模式术前康复的一部分。
评估成人择期大型手术前的多模式术前康复干预措施的研究正在取得令人鼓舞的早期结果，但目前临床效果非常有限。未来的研究应集中于改进干预措施、探索机制、确定最低剂量、研究治疗方法之间的相互作用，并迫切开展大规模临床效果研究。
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