胰十二指肠切除术后患者早期下床活动方案的临床应用研究  

Clinical effect of early ambulation program in patients after pancreaticoduodenectomy

作　　者：王海鑫[1] 沈波[2] 王晓媛[3] Wang Haixin;Shen Bo;Wang Xiaoyuan(Cadre Department,the First Medical Center of People's Liberation Army General Hospital,Beijing 100853,China;Hepatobiliary and Pancreatic Department,the First Medical Center of People's Liberation Army General Hospital,Beijing 100853,China;Sick and Wounded Management Department,the First Medical Center of People's Liberation Army General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心干部诊疗科,北京100853 [2]解放军总医院第一医学中心肝胆胰医学部,北京100853 [3]解放军总医院第一医学中心伤病员管理科,北京100853

出　　处：《中华现代护理杂志》2022年第24期3278-3283,共6页Chinese Journal of Modern Nursing

摘　　要：目的探讨胰十二指肠切除术后患者早期下床活动方案的可行性及有效性。方法采用便利抽样法,选取2020年12月—2021年7月解放军总医院第一医学中心胰十二指肠切除术后患者134例为研究对象,将A病区患者作为试验组,B病区患者作为对照组,每组67例。对照组患者给予常规围手术期护理;试验组患者在常规围手术期护理的基础上,实施胰十二指肠切除术后早期下床活方案。观察试验组患者活动目标完成情况;观察两组患者术后第1天下床活动完成率,术后1~3 d活动距离,活动时疼痛和头晕情况,术后首次排气、排便时间,术后3 d腹胀情况,与活动有关不良事件发生情况。结果试验组患者下床活动第1~3天活动目标达标率分别为100.00%、88.06%、92.54%,腹腔镜手术患者与开腹手术患者每日活动达标率比较无统计学意义(P>0.05)。试验组患者术后第1天下床活动完成率高于对照组,术后第2、3天及1~3 d活动距离多于对照组,术后首次排气、排便时间短于对照组,术后3 d腹胀评分低于对照组,以上差异有统计学意义(P<0.05);试验组首次下床活动疼痛、头晕评分低于对照组,但差异无统计学意义(P>0.05);两组患者在术后早期下床活动过程中均未出现活动不良事件。结论胰十二指肠切除术后患者早期下床活动方案具备可行性及有效性,为医护人员评估和指导胰十二指肠切除术后患者早期下床活动提供了依据和方法。Objective To explore the feasibility and effectiveness of early ambulation program for patients after pancreaticoduodenectomy.Methods From December 2020 to July 2021,convenience sampling was used to select 134 patients after pancreaticoduodenectomy in the First Medical Center of People's Liberation Army General Hospital as the research object.The patients in Ward A were set as the experimental group,and the patients in Ward B were set as the control group,with 67 cases in each group.The patients in the control group were given routine perioperative nursing,and the patients in the experimental group were given an early ambulation program after pancreaticoduodenectomy on the basis of routine perioperative nursing.The completion of the activity goals of the patients in the experimental group was observed.The completion rate of ambulation on the first day after operation,activity distance one to three days after operation,pain and dizziness during activity,time of first exhaust and defecation after operation,abdominal distention and activity-associated adverse events three days after operation were observed in the two groups of patients.Results The compliance rates of ambulation on the first to third days in the experimental group were 100.00%,88.06%,and 92.54%,respectively,and there was no statistical difference in the daily ambulation compliance rate between laparoscopic surgery patients and laparotomy patients(P>0.05).In the experimental group,the completion rate of ambulation of the patients on the first day after operation was higher than that in the control group.On the second,third and first to third days after operation,the activity distances were more than those of the control group.The time of first exhaust and defecation after operation were lower than those of the control group,and the abdominal distension score three days after operation was lower than that of the control group,the above differences were statistically significant(P<0.05).The pain and dizziness scores of the experimental group when ambula

关 键 词：胰十二指肠切除术 早期下床活动 临床应用 

分 类 号：R473.6[医药卫生—护理学]