早期康复训练在肾移植受体患者术后应用的效果观察  

Observation on the effect of early rehabilitation training post operation in renal transplantation recipients

作　　者：李果 赵上萍[3] 王妙维 张霞[1,2] 何成奇 LI Guo;ZHAO Shangping;WANG Miaowei;ZHANG Xia;HE Chengqi(Department of Rehabilitation Medicine,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China;Key Laboratory of Rehabilitation Medicine in Sichuan Province,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China;The 3rd General Ward,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China)

机构地区：[1]四川大学华西医院康复医学中心,成都610041 [2]康复医学四川省重点实验室,成都610041 [3]四川大学华西医院第三综合病房,成都610041

出　　处：《华西医学》2021年第5期578-581,共4页West China Medical Journal

基　　金：四川省科学技术厅重点项目(2019YFS0288)。

摘　　要：目的探讨以早期下床活动为主的康复训练对肾移植受体患者术后首次离床活动时间、早期活动的疼痛、术后感染率以及住院天数的影响。方法回顾性分析2020年6月-8月在四川大学华西医院接受同种异体肾移植手术患者的临床资料。以开始实施多学科术后管理,早期康复介入的时间为分组依据,将患者分为常规组(2020年6月至病房开始术后多学科管理前)和康复组(在病房开始术后多学科管理后)。比较两组患者的术后首次离床活动时间、术后第2天体重监测时的疼痛评分、完成独立步行100 m时间,以及术后并发症、术后感染发生率与住院天数情况。结果共纳入患者79例。其中,常规组46例,康复组33例。纳入患者中,14例发生术后感染,1例发生血栓(常规组),无导管脱落、无运动后出血。康复组与常规组间术后首次离床活动时间[(1.1±0.2)vs.(2.2±0.4)d;t=13.224,P<0.001]、术后第2天体重监测时VAS评分[(2.5±0.9)vs.(3.4±1.4)分;t=3.267,P<0.001]、完成独立步行100 m时间[(2.2±0.4)vs.(4.0±0.8)d;t=11.312,P<0.001]、术后感染发生率(6.1%vs. 26.1%;χ^(2)=5.285,P=0.022)比较,差异均有统计学意义。但康复组的住院天数与常规组比较,差异无统计学意义[(19.8±5.8)vs.(20.7±7.4)d;t=0.584,P=0.561]。结论术后早期康复训练减少了肾移植受者在术后首次离床活动和达到独立步行100 m所需时间,减少了早期活动时的疼痛反应,并降低了术后感染发生率。Objective To explore the effect of rehabilitation training focusing on early exercise on the time of first getting out of bed after surgery, pain during early activities, postoperative infection rate and the length of hospital stay for renal transplant recipients. Methods The clinical data of patients undergoing allogeneic renal transplantation in West China Hospital of Sichuan University from June to August 2020 were analyzed retrospectively. According to the time of multidisciplinary postoperative management and the time of early rehabilitation intervention, the patients were divided into the conventional group(from June 2020 to the beginning of multidisciplinary postoperative management) and the rehabilitation group(after multidisciplinary postoperative management). The time to get out of bed for the first time after surgery, the Visual Analogue Score(VAS) during weight monitoring on the second day post operation, the number of days required to complete an independent walk of 100 meters, postoperative complications, the incidence of postoperative infection and the length of hospital stay were compared between the two groups. Results A total of 79 patients were included. There were 46 cases in the conventional group and 33 cases in the rehabilitation group. Among the included patients, 14 patients had postoperative infection, 1 patients in the conventional group developed thrombosis, no catheter shedding or bleeding after exercise occurred. The differences between the rehabilitation group and the conventional group in the time to get out of bed for the first time after surgery [(1.1±0.2) vs.(2.2±0.4) d;t=13.224, P<0.001], the VAS during weight monitoring on the day post operation(2.5±0.9 vs. 3.4±1.4;t=3.267, P<0.001), the number of days required to complete an independent walk of 100 meters [(2.2±0.4) vs.(4.0±0.8) d;t=11.312, P<0.001], and the incidence of postoperative infection(6.1% vs. 26.1%;χ^(2)=5.285, P=0.022) were statistically significant. There was no significant difference in the length of stay

关 键 词：肾移植受体 康复训练 早期活动 术后疼痛 术后感染 

分 类 号：R699.2[医药卫生—泌尿科学]