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急性 Stanford A 型主动脉夹层累及升主动脉以外部位患者术后的康复进展

Rehabilitation Progress in Patients Following Surgery for Acute Stanford Type A Aortic Dissection Extending Beyond the Ascending Aorta.

作者信息

Nowak Joanna, Listewnik Mariusz, Rył Aleksandra, Pacholewicz Jerzy, Rotter Iwona

机构信息

Department of Cardiac Rehabilitation, Cardiac Surgery Clinic, University Hospital No. 2, 70-111 Szczecin, Poland.

Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, 70-204 Szczecin, Poland.

出版信息

J Clin Med. 2025 Jan 1;14(1):197. doi: 10.3390/jcm14010197.

Abstract

The objective of this study was to assess the course of rehabilitation of patients hospitalized in the cardiac rehabilitation unit after surgery for acute Stanford type A aortic dissection, extending beyond the ascending aorta, and comparing these findings with those for patients who, after the same type of surgery, had no remaining dissection. The aim was to develop an optimal cardiac rehabilitation model for this patient population, given the lack of clear guidelines. Additionally, the study aimed to evaluate their one-year survival. The study included patients referred to the cardiac rehabilitation unit after surgery for acute Stanford type A aortic dissection extending beyond the ascending aorta (a total of 25 patients). The study group was compared with a cohort of patients (a total of 58) who underwent similar cardiac surgery. The main difference was the absence of residual aortic dissection. All patients were assessed on admission to the cardiac rehabilitation unit and at discharge using the 6-min walk test and the Tinetti test. All patients underwent 2-3 weeks of rehabilitation following the same protocol; however, the study group had significantly reduced exercise loads. Patients in the study group were admitted to the cardiac rehabilitation unit in a significantly worse functional status compared to the comparison group, but the final assessment showed comparable results for the Tinetti test and the 6-min walk test. There were no differences in one-year survival between the two groups. Early postoperative cardiac rehabilitation in patients after acute aortic dissection significantly improves the functional status of this patient group, and is safe.

摘要

本研究的目的是评估急性Stanford A型主动脉夹层手术(累及升主动脉以外部位)后入住心脏康复科的患者的康复进程,并将这些结果与接受相同类型手术但无残余夹层的患者的结果进行比较。鉴于缺乏明确的指南,旨在为该患者群体制定最佳的心脏康复模式。此外,该研究旨在评估他们的一年生存率。该研究纳入了急性Stanford A型主动脉夹层手术(累及升主动脉以外部位)后转诊至心脏康复科的患者(共25例)。将研究组与一组接受类似心脏手术的患者(共58例)进行比较。主要区别在于无残余主动脉夹层。所有患者在入住心脏康复科时和出院时均使用6分钟步行试验和Tinetti试验进行评估。所有患者均按照相同方案接受2至3周的康复治疗;然而,研究组的运动负荷明显降低。与对照组相比,研究组患者入住心脏康复科时的功能状态明显较差,但最终评估显示Tinetti试验和6分钟步行试验的结果相当。两组的一年生存率无差异。急性主动脉夹层患者术后早期心脏康复可显著改善该患者群体的功能状态,且安全。

相似文献

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[Late reoperations after repaired Stanford type A aortic dissection].[斯坦福A型主动脉夹层修复术后的晚期再次手术]
Zhonghua Wai Ke Za Zhi. 2017 Apr 1;55(4):266-269. doi: 10.3760/cma.j.issn.0529-5815.2017.04.006.

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