关键词: 心脏瓣膜置换；老年患者；三联预康复；围手术期

Abstract: Objective: To evaluate the effects of trimodal pre-rehabilitation program on older patients undergone cardiac valve replacement during perioperative period. Methods: From November 2021 to November 2022, forty older patients undergone cardiac valve replacement in cardiothoracic and vascular surgery department of a tertiary grade A hospital in Baise city were recruited by convenient sampling method, and were assigned to the control group and the pre-rehabilitation group according to the order of admission time, with 20 cases in each group. Patients in the control group were given routine care, and patients in the pre-rehabilitation group were given trimodal pre-rehabilitation program on the basis of routine care. At 24 hours after admission, 1 day before surgery and 1 day before discharge, the 6-Minute Walking Test, serum prealbumin and serum albumin, anxiety and depression scores of two groups of patients were compared. The time of ventilator use, the time of activity out of bed, length of hospital stay, and some common postoperative complications (including pulmonary infection, acute renal failure) and secondary tractracular intubation incidence were compared between the two groups. Results: After the pre-rehabilitation, the results of 6-Minute Walking Test, serum prealbumin and serum albumin, anxiety and depression scores in the pre-rehabilitation group 1 day before operation and 1 day before discharge were significantly better than those in the control group (P<0.05). The time of ventilator use, the time of activity out of bed and length of hospital stay in the pre-rehabilitation group were significantly better than those in the control group 1 day before discharge (P<0.05). While the incidence of some common postoperative complications (including pulmonary infection, acute renal failure) and secondary tractracular intubation had no statistical significance (P>0.05). Conclusion: The trimodal pre-rehabilitation program can improve the motor function, nutritional status and psychological status of older patients with heart valve replacement surgery during the perioperative period, which can provide reference for promoting postoperative rehabilitation.

Key words: cardiac valve replacement; older patients; trimodal pre-rehabilitation; perioperative period