术前预康复联合术后早期活动对肝脏部分切除术患者恢复的影响  

Effect of preoperative pre-habilitation combined with early postoperative exercise on postoperative recovery of patients who undergoing partial hepatectomy

作　　者：陈璐 刘恋蕊 荚卫东 乔晓斐 CHEN Lu;LIU Lianrui;JIA Weidong;QIAO Xiaofei(Department of General Surgery,The First Affiliated Hospital of University of Science and Technology of China,Hefei 230001,China)

机构地区：[1]中国科学技术大学附属第一医院普外科,安徽合肥230001

出　　处：《肝胆胰外科杂志》2022年第10期616-619,627,共5页Journal of Hepatopancreatobiliary Surgery

摘　　要：目的 探讨术前预康复联合术后早期活动对原发性肝癌和肝脏良性肿瘤接受肝脏部分切除术患者的术后恢复影响。方法 回顾性收集2020年6月至2021年6月在中国科学技术大学附属第一医院接受肝脏部分切除术患者的临床资料。根据护理方案的不同将患者分为两组,观察组采用术前预康复联合术后早期活动进行护理干预,对照组采用常规护理方案。比较两组患者术后第3天进食热卡量、术后住院时间、住院总费用、术后首次肛门排气时间、排便时间及术后并发症的发生率。结果 两组患者在年龄、性别、BMI、疾病类型、ASA分级、手术时间及术中失血量方面差异均无统计学意义(P>0.05)。与对照组比较,观察组患者术后第3天进食热卡量[(665.8±304.9)kcal vs (459.6±201.6)kcal,t=3.537,P=0.001]增加,住院时间[7.0(5.3,8.8)d vs 8.0(7.0,12.0)d,Z=-3.596,P<0.001]和住院总费用[(29 518.9±7 943.1)元 vs (34 460.1±9 622.3)元,t=-2.492,P=0.015]降低,差异具有统计学意义。两组患者术后首次肛门排气时间、排便时间的差异无统计学意义(P>0.05)。结论 术前预康复联合术后早期活动能增加患者术后第3天进食热卡量,缩短术后住院时间,减少住院总费用,有助于患者术后快速康复。objective To investigate the effect of preoperative pre-habilitation combined with early postoperative exercise on the postoperative recovery of patients who underwent partial hepatectomy. Methods Clinical data were retrospectively collected from patients who undergoing partial hepatectomy from Jun. 2020 to Jun. 2021. Patients were divided into observation and control groups according to the nursing schemes. Patients in the observation group received the postoperative nursing intervention of preoperative pre-habilitation combined with early postoperative exercise. Patients in the control group received the routine hursing plan. The amount of caloric intake on the third day after surgery, the postoperative hospitalization time, the total hospital expenses, the time to first postoperative anal discharge and defecation, and the incidence of postoperative complications were compared between the two groups. Results There was no significant difference between the two groups in terms of age, gender, BMI, type of disease, ASA classification, operative time and intraoperative blood loss(all P>0.05). The amount of caloric intake in the observation group on the third day after surgery was significantly higher than that in the control group [(665.8±304.9) kcal vs(459.6±201.6) kcal, t=3.537, P=0.001]. The postoperative hospitalization time was significantly shorter in the observation group than that in the control group [7.0(5.3, 8.8)d vs 8.0(7.0, 12.0)d, Z=-3.596, P<0.001]. The total hospitalization expenses in the observation group was significantly lower than that in the control group [(29 518.9±7 943.1) yuan vs(34 460.1±9 622.3) yuan, t=-2.492, P=0.015]. However, there was no significant difference in the time to first postoperative anal discharge and defecation between the two groups(all P>0.05). Conclusion Preoperative pre-habilitation combined with early postoperative exercise can increase patients caloric intake on the third day after surgery, shorten the postoperative hospitalization time and reduce the total hos

关 键 词：术前预康复 术后早期活动 肝部分切除术 手术护理 

分 类 号：R657.3[医药卫生—外科学] R473.6[医药卫生—临床医学]