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Ann Surg:术前运动康复锻炼可降低高危老年患者择期结直肠切除术后并发症的风险

2021-01-26 MedSci原创 MedSci原创

果真,多运动好处多多!

既往研究显示,接受结直肠切除手术的患者,术前有氧适应能力低,术后并发症的风险就会增加。然而,对这些患者进行康复治疗是否能减少术后并发症仍有待证实。

本研究旨在评估为期3周的社区锻炼计划对因恶性肿瘤或癌前病变行择期结直肠切除术的高危患者术后30天并发症发生率的影响。

研究流程

这是一项在荷兰的两家大型教学医院开展的前瞻性、单盲随机临床试验。招募≥60岁拟行择期结直肠切除术、且退伍军人专项活动问卷≤7分的患者,随机分为康复组和常规护理组。康复组的患者在结直肠切除术前参加了为期3周的个性化锻炼计划(每周3次,共9次);对照组患者接受常规护理。主要评估指标是术后30天内出现一种或多种并发症的患者人数。

患者康复锻炼前后的通气功能

2014年2月-2018年12月,共招募了57位患者(男性30位;平均73.6岁[标准差6.1岁,范围61-88岁]),随机分至康复组(n=28)或常规护理组(n=29)。康复组的术后并发症发生率(n=12,42.9%)低于常规护理组(n=21,72.4%,相对风险 0.59,95%CI 0.37~0.96,P=0.024)

综上,术前运动康复可降低接受择期结肠切除术的高危患者的术后并发症的发生风险。对于拟行选择性结直肠手术的高危患者,术前进行运动康复锻炼治疗应考虑纳入常规护理。

原始出处:

Berkel Annefleur E M,Bongers Bart C,Kotte Hayke et al. Effects of Community-based Exercise Prehabilitation for Patients Scheduled for Colorectal Surgery With High Risk for Postoperative Complications: Results of a Randomized Clinical Trial. Ann Surg, 2021, https://doi.org/10.1097/SLA.0000000000004702

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1877377, encodeId=f1bf18e737796, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Wed Jun 02 03:16:39 CST 2021, time=2021-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1758308, encodeId=f6bc1e583083b, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Mon Jun 21 02:16:39 CST 2021, time=2021-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1453462, encodeId=181914534628f, content=<a href='/topic/show?id=098ee8679ad' target=_blank style='color:#2F92EE;'>#结直肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78679, encryptionId=098ee8679ad, topicName=结直肠)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9ace5575596, createdName=crystal0564, createdTime=Thu Jan 28 08:16:39 CST 2021, time=2021-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=920287, encodeId=41c892028e8a, content=好文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55555437851, createdName=曹江波, createdTime=Wed Jan 27 14:11:55 CST 2021, time=2021-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1050343, encodeId=278610503432b, content=运动锻炼应该是健康第一要素,对各类疾病都应该有益。但是国内这方面研究太少, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=jingjing, createdTime=Tue Jan 26 20:16:39 CST 2021, time=2021-01-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=920051, encodeId=78e292005161, content=很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=07ec5456064, createdName=ms1000001657529247, createdTime=Tue Jan 26 17:27:54 CST 2021, time=2021-01-26, status=1, ipAttribution=)]
    2021-06-21 丁鹏鹏
  3. [GetPortalCommentsPageByObjectIdResponse(id=1877377, encodeId=f1bf18e737796, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Wed Jun 02 03:16:39 CST 2021, time=2021-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1758308, encodeId=f6bc1e583083b, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Mon Jun 21 02:16:39 CST 2021, time=2021-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1453462, encodeId=181914534628f, content=<a href='/topic/show?id=098ee8679ad' target=_blank style='color:#2F92EE;'>#结直肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78679, encryptionId=098ee8679ad, topicName=结直肠)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9ace5575596, createdName=crystal0564, createdTime=Thu Jan 28 08:16:39 CST 2021, time=2021-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=920287, encodeId=41c892028e8a, content=好文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55555437851, createdName=曹江波, createdTime=Wed Jan 27 14:11:55 CST 2021, time=2021-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1050343, encodeId=278610503432b, content=运动锻炼应该是健康第一要素,对各类疾病都应该有益。但是国内这方面研究太少, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=jingjing, createdTime=Tue Jan 26 20:16:39 CST 2021, time=2021-01-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=920051, encodeId=78e292005161, content=很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=07ec5456064, createdName=ms1000001657529247, createdTime=Tue Jan 26 17:27:54 CST 2021, time=2021-01-26, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1877377, encodeId=f1bf18e737796, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Wed Jun 02 03:16:39 CST 2021, time=2021-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1758308, encodeId=f6bc1e583083b, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Mon Jun 21 02:16:39 CST 2021, time=2021-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1453462, encodeId=181914534628f, content=<a href='/topic/show?id=098ee8679ad' target=_blank style='color:#2F92EE;'>#结直肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78679, encryptionId=098ee8679ad, topicName=结直肠)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9ace5575596, createdName=crystal0564, createdTime=Thu Jan 28 08:16:39 CST 2021, time=2021-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=920287, encodeId=41c892028e8a, content=好文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55555437851, createdName=曹江波, createdTime=Wed Jan 27 14:11:55 CST 2021, time=2021-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1050343, encodeId=278610503432b, content=运动锻炼应该是健康第一要素,对各类疾病都应该有益。但是国内这方面研究太少, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=jingjing, createdTime=Tue Jan 26 20:16:39 CST 2021, time=2021-01-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=920051, encodeId=78e292005161, content=很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=07ec5456064, createdName=ms1000001657529247, createdTime=Tue Jan 26 17:27:54 CST 2021, time=2021-01-26, status=1, ipAttribution=)]
    2021-01-27 曹江波

    好文章

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1877377, encodeId=f1bf18e737796, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Wed Jun 02 03:16:39 CST 2021, time=2021-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1758308, encodeId=f6bc1e583083b, content=<a href='/topic/show?id=84ba49031f9' target=_blank style='color:#2F92EE;'>#并发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49031, encryptionId=84ba49031f9, topicName=并发)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a27e37327108, createdName=丁鹏鹏, createdTime=Mon Jun 21 02:16:39 CST 2021, time=2021-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1453462, encodeId=181914534628f, content=<a href='/topic/show?id=098ee8679ad' target=_blank style='color:#2F92EE;'>#结直肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78679, encryptionId=098ee8679ad, topicName=结直肠)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9ace5575596, createdName=crystal0564, createdTime=Thu Jan 28 08:16:39 CST 2021, time=2021-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=920287, encodeId=41c892028e8a, content=好文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55555437851, createdName=曹江波, createdTime=Wed Jan 27 14:11:55 CST 2021, time=2021-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1050343, encodeId=278610503432b, content=运动锻炼应该是健康第一要素,对各类疾病都应该有益。但是国内这方面研究太少, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=jingjing, createdTime=Tue Jan 26 20:16:39 CST 2021, time=2021-01-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=920051, encodeId=78e292005161, content=很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=07ec5456064, createdName=ms1000001657529247, createdTime=Tue Jan 26 17:27:54 CST 2021, time=2021-01-26, status=1, ipAttribution=)]
    2021-01-26 jingjing

    运动锻炼应该是健康第一要素,对各类疾病都应该有益。但是国内这方面研究太少

    0

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    2021-01-26 ms1000001657529247

    很好

    0

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与成人一样,卒中是SARS-CoV-2患儿罕见的并发症,仅4.7%的缺血性卒中患儿检出SARS-CoV-2阳性。

JNNP:慢性炎症性脱髓鞘性多发性神经根病中糖尿病和其他并发症的发生频率及其对临床表现和治疗反应的影响

目的:确定慢性发炎性脱髓鞘性多发性神经根神经病(CIDP)中不同合并症的患病率及其对结局,治疗选择和反应的影响。

腹主动脉瘤腔内治疗后随访期并发症及处理

EVAR因具有创伤小、出血少、术后恢复快等优点,已成为腹主动脉瘤的主要治疗方法。随着经验的积累和器材的逐步完善,操作技术的日臻成熟,治疗适应证也更加广泛。

GW-ICC 2020:苏晞:冷冻消融并发症的真实数据和管理

肺静脉隔离(PVI)是心房颤动导管消融的基石,应用冷冻球囊导管进行肺静脉隔离的有效性和安全性获得了临床研究证实,国内外指南已将冷冻球囊消融(CBA)作为房颤消融的标准疗法。

Gastric Cancer:术后并发症对胃癌患者生存结局的影响

胃癌是第五种最常见的癌症,也是世界上与癌症有关的死亡的第三大主要原因, 外科手术切除是治疗晚期胃癌的最有效的手段,但是术后并发症会对患者的生活质量产生不利影响。

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