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[主动脉冠状动脉搭桥手术后的职业康复]

[Occupational rehabilitation following aorto-coronary bypass operations].

作者信息

Speiser K, Pfluger N, Rothlin M

出版信息

Schweiz Med Wochenschr. 1982 Aug 3;112(31-32):1095-8.

PMID:6982511
Abstract

Resumption of work after aorto-coronary bypass surgery was studied in 317 patients with a mean age of 51 years. 217 patients who underwent surgery between 1975 and 1978 were studied retrospectively (group I) and 100 patients operated upon between 1979 and 1980 prospectively (group II). A coronary control study was performed in 106 patients of group I and in all patients of group II. Age, postoperative NYHA class, and pre- and postoperative ejection fraction did not differ in the two groups. Significant differences between the two groups were found regarding preoperative NYHA class (2.9 vs 2.5), amount of diseased coronary vessels (2.3 vs 2.6), number of bypass grafts (2.4 vs 3,2, all p's less than 0.001) and graft patency rate (70 vs 80%, p less than 0.025). One year after surgery 78% in group I and 84% in group II were back at work (ns). However, among the patients not working before surgery, 54% in group I and 73% in group II had returned to work (p less than 0.005), which indicates a greater success rate for aorto-coronary bypass grafting in recent years. Best predictors for resumption of work after surgery are relief of symptoms, normal work capacity in the bicycle test, duration of inability to work before surgery and type of occupation.

摘要

对317例平均年龄为51岁的患者进行了主动脉冠状动脉搭桥手术后复工情况的研究。对1975年至1978年间接受手术的217例患者进行了回顾性研究(第一组),对1979年至1980年间接受手术的100例患者进行了前瞻性研究(第二组)。对第一组的106例患者和第二组的所有患者进行了冠状动脉对照研究。两组患者的年龄、术后纽约心脏协会(NYHA)分级以及术前和术后射血分数无差异。两组之间在术前NYHA分级(2.9对2.5)、病变冠状动脉血管数量(2.3对2.6)、搭桥血管数量(2.4对3.2,所有p值均小于0.001)和血管通畅率(70%对80%,p小于0.025)方面存在显著差异。手术后一年,第一组78%的患者和第二组84%的患者恢复工作(无统计学差异)。然而,在术前未工作的患者中,第一组54%的患者和第二组73%的患者已恢复工作(p小于0.005),这表明近年来主动脉冠状动脉搭桥术的成功率更高。手术后复工的最佳预测因素是症状缓解、自行车试验中的正常工作能力、术前无法工作的持续时间和职业类型。

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