[接受自体静脉冠状动脉搭桥手术的缺血性心脏病患者的康复潜力在康复治疗效果评估中的应用]。

S G Abramovich, O O Knyazyuk, I M Mikhalevich, V A Drobyshev, E A Shchedreeva
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引用次数: 0

摘要

寻找对接受冠状动脉搭桥手术(CABS)的缺血性心脏病(IHD)患者的康复潜力(RP)进行评估的方法仍具有现实意义,这将使针对特定患者的必要治疗综合方案的个性化管理方法成为可能,从而提高其有效性并降低并发症的发生概率:开发一种方法,用于对接受 CABS 的 IHD 患者进行 RP 评估,并评估其在预测早期康复期治疗活动有效性方面的作用:研究由两部分组成。第一部分是在使用数学建模方法分析出院报告的基础上,对 118 名年龄在 36-85 岁(平均年龄为 62.3±2.0 岁)接受 CABS 的 IHD 患者进行 RP 评估。在研究的第二部分,对心血管外科手术后转入安加拉临床度假村心血管科进行第二阶段康复治疗的患者的康复活动结果进行了分析。多学科小组在患者康复结束后,利用表征接受心血管外科手术患者临床状况的综合指标对患者的治疗效果进行了评估:研究的第一部分创建了一个方法算法,即形成了一个正式的病人图表,证据基础由 99 个指标表示。将线性分类函数的系数值分配给某些指标,根据这些指标将患者分为四组:第一组--无RP;第二组--中等RP;第三组--高RP;第四组--低RP。研究的第二部分确定了 RP 值,以预测早期康复期(医疗康复的第二阶段)治疗措施的效果。研究发现,在疗养院治疗后的患者测试中,RP 值较高的第三组受试者的效果最好。第二组,尤其是第四组患者的效果较差:在接受 CABS 的患者中使用基于数学建模的 RP 评估方法,可以预测患者在疗养院条件下第二阶段医疗康复的结果。
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[Rehabilitation potential of patients with ischemic heart disease who underwent autovenous coronary artery bypass surgery in the evaluation of rehabilitation treatment effectiveness].

The search for methods to assess the rehabilitation potential (RP) of patients with ischemic heart disease (IHD) who underwent coronary artery bypass surgery (CABS), which will allow to personalize approaches to the administration of necessary for the certain patient treatment complexes, increasing their effectiveness and reducing the probability of complications, remains relevant.

Objective: To develop a method for RP evaluation in patients with IHD who underwent CABS and to assess its role in predicting the effectiveness of therapeutic activities in the early rehabilitation period.

Material and methods: The study consisted of two parts. A method for RP assessment in 118 patients with IHD aged 36-85 years (mean age 62.3±2.0 years) who underwent CABS was developed in the 1st part based on the analysis of hospital discharge reports using mathematical modeling methods. The results of rehabilitation activities were analyzed in the 2nd part of the study in patients who were transferred to the cardiovascular department of the Angara Clinical Resort after the cardiovascular surgery department for the second stage of rehabilitation. The multidisciplinary team evaluated the effectiveness of patients' treatment after the rehabilitation completion using integral indicators characterizing clinical condition of the patient who underwent CABS.

Results: A methodological algorithm was created in the 1st part of the study, namely a formalized patient chart was formed, the evidence base was represented by 99 indicators. The values of linear classification functions' coefficients were assigned to certain indicators, according to which the patient was classified into one of four groups: the 1st group - without RP; the 2nd group - with medium RP; the 3rd group - with high RP and the 4th group - with low RP. The values of RP were determined in the second part of the study for predicting the effectiveness of therapeutic measures in the early rehabilitation period (the second stage of medical rehabilitation). It has been found that the greatest effect was observed in subjects of the 3rd group with high RP in the patients' testing after treatment at the health resort. The lesser effect has been noted in patients of the 2nd group and especially of the 4th group.

Conclusions: The use of RP assessment method based on mathematical modeling in patients who underwent CABS allows to predict the results of patients' medical rehabilitation at the second stage in the health resort conditions.

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来源期刊
CiteScore
0.60
自引率
0.00%
发文量
59
期刊介绍: The journal deals with the study of the mechanism of a physiological and therapeutic effect of physical and health resort factors, methods and results of their employment, as well as with theoretical and practical problems involved in the use of exercise therapy in combined treatment of different diseases. The results of research and experience of using physical and health resort methods in medical practice and organization of physiotherapeutic and sanatorial and health resort service, book reviews on physiotherapy, health resort science and exercise therapy are published. Scientific life of allied specialities, proceedings of congresses, conferences, symposia (including foreign), the activity of republican and local societies, etc., are covered.
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