【摘要】 目的：探讨基于衰弱评估指导下的关怀干预模式对机器人辅助心脏手术患者远期生存率及心肺功能重建的影响。方法：选取2020年5月—2022年4月于西安交通大学第一附属医院行机器人辅助心脏手术治疗的92例患者为研究对象，按干预方法将其分为对照组（n=46，行常规干预）与研究组（n=46，行基于衰弱评估指导下的关怀干预）。比较两组远期生存率、心肺功能指标、步行距离、衰弱程度及生活质量。结果：相较于对照组，研究组在术后1年、2年及3年的生存率更高（P<0.05）。与干预前相比，两组干预后FEV₁、FEV₁%、AT、VO₂max指标均有所上升（P<0.05），且研究组干预3个月、6个月时的上述指标水平较对照组更高（P<0.05）。与干预前相比，两组干预后的6MWT距离均有所提升，且研究组在干预3个月、6个月时的6MWT距离较对照组更长（P<0.05）。两组干预后FRAIL评分、CFS评分较干预前均有所降低，且研究组干预3个月、6个月后的FRAIL评分、CFS评分较对照组更低（P<0.05）。与干预前相比，两组干预后SAQ评分均上升（P<0.05），且研究组干预3个月、6个月后的SAQ评分较对照组更高（P<0.05）。结论：相较于常规干预，在机器人辅助心脏手术患者中应用基于衰弱评估指导下的关怀干预模式更具优势，可显著提升患者远期生存率，并有效改善心肺功能恢复、缓解衰弱状态及提高生活质量。更多还原

【Abstract】 Objective: To investigate the frailty assessment-guided care intervention model on long-term survival rate and cardiopulmonary function recovery in patients undergoing robot-assisted cardiac surgery. Methods: 92 patients who underwent robotassisted cardiac surgery at the First Affiliated Hospital of Xi’an Jiaotong University from May 2020 to April 2022 were enrolled. They were divided into the control group（n=46, receiving routine care） and the study group（n=46, receiving frailty assessment-guided care intervention） based on intervention type. Long-term survival rate, cardiopulmonary function indicators, 6-minute walk test（6 MWT）, distance frailty status, and quality of life were compared between the two groups. Results: Compared with the control group, the study group has significantly higher survival rates at 1, 2, and 3 years after surgery（P<0.05）. Compared with that before intervention, both groups showed significant improvements in FEV₁, FEV₁%, anaerobic threshold（AT）, and VO₂ max after intervention（P<0.05）, and the study group showed significantly higher levels of these indicators at 3 and 6 months after intervention than the control group（P<0.05）. After intervention, 6 MWT distance increased in the two groups（P<0.05）, with the study group achieving significantly longer distances at 3 and 6 months after intervention than the control group（P<0.05）. FRAIL and clinical frailty scale（CFS） scores were significantly decreased in both groups after intervention（P<0.05）, with the study group showing significantly lower scores than the control group at 3 and 6 months after intervention（P<0.05）. The Seattle angina questionnaire（SAQ） scores increased significantly in both groups after intervention（P<0.05）, and the study group scored significantly higher than the control group at 3 and 6 months after intervention（P<0.05）. Conclusion: Compared with routine care, the frailty assessment-guided care intervention has superior efficacy in patients undergoing robot-assisted cardiac surgery, which can significantly improve long-term survival rate, promote cardiopulmonary function recovery, alleviate frailty, and enhance quality of life.更多还原