关键词: 冠脉搭桥术, 心脏康复, 一体化管理模式

Abstract: Objective To investigate the effect of integrated management mode in patients after coronary artery bypass grafting. Methods A total of 60 patients who underwent coronary artery bypass grafting in Department of Cardiac Surgery, Ruijin Hospital, from August 2016 to May 2018 were enrolled, and according to their will, they were divided into integrated management group (observation group) and control group, with 30 patients in each group. Both groups were given standard rehabilitation treatment during hospitalization; after discharge, the patients in the control group received rehabilitation treatment at home based on the rehabilitation regimen provided by the physician and were followed up regularly at the outpatient service. For the patients in the observation group, a community health service institution was selected by the physician in charge and the patient to perform long-term cardiac rehabilitation, and the implementation of the cardiac rehabilitation regimen was supervised by the surgical physician, the rehabilitation physician, and the rehabilitation therapist; meanwhile, the patients were followed up regularly by telephone and received visits for supervision, timely evaluation, and further guidance. Activity tolerance was evaluated using the six-minute walk test during the outpatient follow-up at 3 months, half a year, and a year after enrollment, and the data on adverse events related to early visit or hospitalization due to exacerbation of disease conditions were also recorded throughout follow-up. Results There was a continuous improvement in six-minute walk distance at 3 months, half a year, and a year after enrollment in both the observation group and the control group, with a significant difference between time points (P<0.01), and the observation group had a significantly greater improvement than the control group at each time point (P<0.01). There was no significant difference in the incidence rate of adverse events within 1 year between the observation group and the control group (P>0.05). Conclusion The integrated management mode in which the implementation of cardiac rehabilitation regimen is supervised by surgical physician, rehabilitation physician, and rehabilitation therapist has a marked effect in improving patients' activity ability after coronary artery bypass grafting and thus holds promise for further application, while it has no marked effect in preventing adverse events (including readmission) caused by heart issues after surgery, which requires further studies.

Key words: Coronary artery bypass grafting, Cardiac rehabilitation, Integrated management mode