论文部分内容阅读
目的:探讨协同护理模式下早期运动干预对腹腔镜结直肠癌手术患者康复效果的影响。方法:采用整群抽样,选取2019年1—3月行腹腔镜手术的结直肠癌患者为研究对象,对符合标准的患者以科室为单位随机(抛硬币法)分为试验组和对照组,最终试验组47例,对照组49例,对照组接受普外科围手术期常规护理及术后运动指导,试验组在常规护理的基础上增加协同式早期运动干预。主要比较2组患者身体状况、术后4周运动能力水平恢复率,其次比较住院期间运动耐量(离床活动时间)、出院准备时间、胃肠功能恢复时间、并发症发生率。结果:试验组在术后当天运动目标达标率最低为42.6%(20/47),在术后第4天运动达标率最高为89.4%(42/47);试验组每日离床活动时间均高于对照组,差异有统计学意义(n Z值为-8.437~-7.381,n P<0.01)。试验组胃肠功能恢复时间及术后第3天多维疲劳量表得分分别为(58.74 ± 17.41)h、(59.02 ± 9.46)分,对照组分别为(71.82 ± 21.53)h、(62.61 ± 7.68)分,差异有统计学意义(n t值为-3.263、-2.046,n P0.05)。n 结论:协同式早期运动干预能提高腹腔镜结直肠癌手术患者早期运动依从性,能有效改善运动耐量、胃肠功能恢复时间,能缓解术后疲劳状况,促进早期康复。“,”Objective:To evaluate the rehabilitation efficacy of early mobilization based on collaboration care model for patients with laparoscopic colorectal surgery.Methods:Cluster sampling method was used in the department to recruit colorectal cancer patients with laparoscopic surgery. The control group (49 cases) received routine perioperative care and exercise, and the intervention group (47 cases) received the coordinated early mobilization combined with routine perioperative care and exercise, from January to March 2019. Primary outcome were health status and the proportion of patients returning to preoperative functional walking capacity (6-min walk test) at 4 weeks after surgery. The in-hospital mobilization (time out-of-bed), time to achieve discharge criteria, time to recover gastrointestinal function and complication rate were explored.Results:In intervention group,89.4%(42/47) of patients achieved mobilization target on 4 days after surgery compared with 42.6%(20/47) on the day of surgery. Time out of bed were greater in the intervention group compared with the control group, and there were differences between the two groups(n Z values were -8.437--7.381, n P<0.01). Time to recover gastrointestinal function and the recovery of energy on 3 days after surgery were (58.74±17.41) h, (59.02±9.46) points in the observation group, and (71.82±21.53) h, (62.61±7.68) points in the control group, and there were significant differences between the two groups (n t values were -3.263, -2.046, n P0.05).n Conclusions:For colorectal laparoscopic surgery patients, the coordinated early mobilization improved the adherence to ambulation, in-hospital mobilization, time to recover gastrointestinal function and recovery of energy to promote rehabilitation.