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早期活动以促进心房颤动患者心脏瓣膜手术后的恢复:一项随机对照试验。

Early mobilisation to enhance recovery following cardiac valvular surgery in atrial fibrillation patients: a randomised controlled trial.

作者信息

Gao Zhen, Fan Chengming, Zeng Bo, Song Long, Tian Liqing

机构信息

Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.

Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, 139 Renmin Middle Road, Changsha, Hunan, China.

出版信息

Sci Rep. 2025 Jul 16;15(1):25701. doi: 10.1038/s41598-025-10004-2.

Abstract

This study aimed to assess the feasibility and safety of early mobilisation in promoting enhanced recovery among patients with concurrent atrial fibrillation undergoing cardiac valve surgery. A total of 190 patients who underwent cardiac valve surgery with concurrent atrial fibrillation at a tertiary-grade A hospital in Changsha City between January and December 2022 were randomly allocated to either an intervention (n = 95) or a control group (n = 95). The control group received standard perioperative care, while the intervention group followed a care programme that integrated conventional and Enhanced Recovery After Surgery (ERAS) protocols. The study compared recovery progress, incidence of complications, and various other metrics between the two groups. The intervention group demonstrated statistically. significant differences (p < 0.01) compared to the control group in terms of time to first mobilisation, duration of intensive care unit (ICU) stay, mechanical ventilation duration, pain scores, 6-minute walking distances, occurrence of arrhythmias, ICU re-admission, pulmonary infection rates, sternal incision infection rates, length of hospital stay, hospitalisation expenses, and adverse event rates. Summarily, patients in the intervention group exhibited more favourable outcomes across these metrics than those in the control group. Implementing an ERAS protocol-based early mobilisation strategy is a safe and viable approach for patients undergoing cardiac valve surgery with concurrent atrial fibrillation, facilitating their expedited recovery.

摘要

本研究旨在评估早期活动在促进合并心房颤动的心脏瓣膜手术患者加速康复中的可行性和安全性。2022年1月至12月期间,在长沙市一家三级甲等医院接受心脏瓣膜手术并合并心房颤动的190例患者被随机分为干预组(n = 95)和对照组(n = 95)。对照组接受标准围手术期护理,而干预组遵循一项整合了传统和术后加速康复(ERAS)方案的护理计划。该研究比较了两组之间的康复进程、并发症发生率及其他各项指标。干预组在首次活动时间、重症监护病房(ICU)住院时间、机械通气时间、疼痛评分、6分钟步行距离、心律失常发生率、ICU再入院率、肺部感染率、胸骨切口感染率、住院时间、住院费用和不良事件发生率等方面与对照组相比,差异有统计学意义(p < 0.01)。总体而言,干预组患者在这些指标上的预后比对照组更有利。对合并心房颤动的心脏瓣膜手术患者实施基于ERAS方案的早期活动策略是一种安全可行的方法,有助于他们加快康复。

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