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全内镜心脏手术后90天以患者为中心的结局:一项前瞻性队列研究。

90-Day Patient-Centered Outcomes after Totally Endoscopic Cardiac Surgery: A Prospective Cohort Study.

作者信息

Claessens Jade, Yilmaz Alaaddin, Mostien Toon, Van Genechten Silke, Claes Marithé, Packlé Loren, Pierson Maud, Vandenbrande Jeroen, Kaya Abdullah, Stessel Björn

机构信息

Faculty of Medicine and Life Sciences, UHasselt-Hasselt University, Agoralaan, 3590 Diepenbeek, Belgium.

Department of Cardiothoracic Surgery, Jessa Hospital, Stadsomvaart 11, 3500 Hasselt, Belgium.

出版信息

J Clin Med. 2022 May 9;11(9):2674. doi: 10.3390/jcm11092674.

Abstract

Over the past years, minimally invasive procedures have been developed to reduce surgical trauma after cardiac surgery. The value of patient-centered outcomes, including the quality of recovery after hospital discharge, is increasingly recognized. Identifying meaningful changes in postoperative function that might have a negative impact on patients without noticeable complications can provide a more comprehensive understanding of the impact on the patient's life. In total, 209 patients were included in this trial. Of these, 193 patients underwent totally endoscopic cardiac surgery, 8 underwent cardiac surgery through a sternotomy, and 8 underwent transcatheter aortic valve implantation. Patients who previously underwent cardiac surgery were excluded. Quality of life was determined through the Short Form 36 and European Quality of Life-5 Dimensions questionnaires before the surgery and 14, 30, and 90 days afterward. In patients who underwent totally endoscopic cardiac surgery, the quality of life improved over the three time periods. The different domains of the questionnaire evolved in a positive manner. However, 14 days postoperatively, a decline in quality of life was noted, followed by a return to baseline at 30 days and an increase at 90 days. In conclusion, totally endoscopic cardiac surgery improves the quality of life 90 days after surgery.

摘要

在过去几年中,已经开发出微创手术以减少心脏手术后的手术创伤。以患者为中心的结果的价值,包括出院后恢复的质量,越来越受到认可。识别术后功能的有意义变化,这些变化可能对没有明显并发症的患者产生负面影响,可以更全面地了解对患者生活的影响。本试验共纳入209例患者。其中,193例患者接受了完全内镜心脏手术,8例通过胸骨切开术进行心脏手术,8例接受经导管主动脉瓣植入术。既往接受过心脏手术的患者被排除在外。在手术前以及术后14天、30天和90天,通过简短健康调查问卷36项版本和欧洲五维度健康量表问卷来确定生活质量。在接受完全内镜心脏手术的患者中,生活质量在这三个时间段有所改善。问卷的不同领域呈积极变化。然而,术后14天,生活质量出现下降,随后在30天恢复到基线水平,并在90天有所提高。总之,完全内镜心脏手术可改善术后90天的生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23d2/9103144/7a405d9faecd/jcm-11-02674-g001.jpg

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