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女性心脏手术后的短期恢复:实践建议

Short-term recovery from cardiac surgery in women: suggestions for practice.

作者信息

King K M, Collins-Nakai R L

机构信息

Division of Cardiology, WC Mackenzie Centre, University of Alberta, Edmonton.

出版信息

Can J Cardiol. 1998 Nov;14(11):1367-71.

PMID:9854518
Abstract

OBJECTIVE

To examine the effect of sex on short-term recovery from cardiac surgery.

DESIGN

Prospective, nonrandomized design. Men and women undergoing elective cardiac surgery were interviewed in the immediate preoperative period and monthly by telephone through the third postoperative month.

SETTING

Subjects were recruited from three cardiac surgery referral centres in western Canada.

PATIENTS

One hundred and thirty-two consecutive patients entering the hospital for coronary artery bypass and/or valve surgery were recruited. Inclusion criteria required that subjects be able to communicate effectively and to live independently. One hundred and twenty subjects completed the study--60 men and 60 women; 30 of each sex group were less than 65 years of age and 30 were 65 years and older.

MAIN RESULTS

Women were more functionally impaired, had less social support and reported lower life satisfaction than men preoperatively. There were no significant differences between the sexes in the outcome measures three months postoperatively, and neither age nor sex consistently predicted outcome at the three-month end-point. Sex-specific issues reflect the social circumstances from which women entered the process of having their heart disease diagnosed and undergoing cardiac surgery.

CONCLUSIONS

Findings support recent conclusions that there are few differences between men and women in the recovery from cardiac surgery; however, the existing differences warrant serious consideration for changes in current clinical practice. Sex differences included women's poorer preoperative functional status, lesser social support and differences in the nature of work women return to following their surgery.

摘要

目的

研究性别对心脏手术后短期恢复的影响。

设计

前瞻性、非随机设计。对接受择期心脏手术的男性和女性在术前即刻进行访谈,并在术后第三个月内每月通过电话进行随访。

地点

研究对象从加拿大西部的三个心脏手术转诊中心招募。

患者

连续招募了132例因冠状动脉搭桥和/或瓣膜手术入院的患者。纳入标准要求受试者能够有效沟通且独立生活。120名受试者完成了研究,其中男性60名,女性60名;每个性别组中有30名年龄小于65岁,30名年龄在65岁及以上。

主要结果

术前女性在功能上受损更严重,获得的社会支持更少,生活满意度也低于男性。术后三个月的各项结局指标在性别上无显著差异,年龄和性别在三个月的终点时均不能持续预测结局。特定性别的问题反映了女性在被诊断患有心脏病并接受心脏手术过程中所处的社会环境。

结论

研究结果支持最近的结论,即男性和女性在心脏手术后的恢复方面差异不大;然而,现有的差异值得在当前临床实践中进行认真考虑。性别差异包括女性术前较差的功能状态、较少的社会支持以及术后回归工作性质的差异。

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