三联预康复策略对胰十二指肠切除术患者的临床应用效果  

Clinical effect of trimodal pre-rehabilitation strategy in patients undergoing pancreatoduodenectomy

作　　者：余鸿[1] 许武英[1] 徐新建[1] YU Hong;XU Wuying;XU Xinjian(Department of Pancreatic Surgery,the First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang,830011)

机构地区：[1]新疆医科大学第一附属医院胰腺外科,新疆乌鲁木齐830011

出　　处：《实用临床医药杂志》2024年第1期94-97,共4页Journal of Clinical Medicine in Practice

基　　金：国家自然科学基金项目(82160491);新疆维吾尔自治区自然科学基金项目(2019D01C302);新疆医科大学第一附属医院“青年科研起航专项基金”资助项目(YFY2022-14)。

摘　　要：目的观察三联预康复策略对行胰十二指肠切除术患者的临床应用效果。方法选取择期行胰十二指肠切除术的110例患者为研究对象。患者按照入组奇偶顺序随机分为对照组和观察组,每组55例。对照组围术期给予常规护理,观察组在对照组的基础上于术前实施三联预康复护理。观察并比较2组患者的心理状态、生活质量以及术后相关指标与并发症发生情况。检测2组患者的血清白蛋白(ALB)、前白蛋白(PA)、转铁蛋白(TRF)水平。结果观察组术后排气、下床、首次经口进食时间和住院时间均短于对照组,差异有统计学意义(P<0.05)。术前1 d和术后14 d,观察组的ALB、PA、TRF水平及36项简明健康调查量表(SF-36)评分高于对照组,医院焦虑抑郁量表(HADS)评分低于对照组,差异有统计学意义(P<0.05或P<0.01)。观察组术后肺部感染、静脉血栓发生率低于对照组,差异有统计学意义(P<0.05)。结论三联预康复护理干预措施可有效改善胰十二指肠切除术患者围术期的营养状况和心理状态,提高其生活质量,降低并发症发生率。Objective To observe the clinical effect of trimodal pre-rehabilitation strategy in patients undergoing pancreatoduodenectomy.Methods A total of 110 patients undergoing elective pancreaticoduodenectomy were selected as the study objects.Patients were randomly divided into control group and observation group according to the odd-even order,with 55 cases in each group.The control group was given routine nursing during perioperative period,and the observation group was given trimodal pre-rehabilitation nursing before surgery based on the control group.The psychological state,quality of life,postoperative indexes and complications of the two groups were observed and compared.Serum albumin(ALB),prealbumin(PA)and transferrin(TRF)levels were detected in two groups.Results Postoperative exhaust time,getting out of bed time,first oral feeding time and hospital stay in the observation group were significantly shorter than those in the control group(P<0.05).At 1 day before surgery and 14 days after surgery,the levels of ALB,PA,TRF and 36-item Short Form Health Assessment Scale(SF-36)in the observation group were significantly higher than those in the control group,and the Hospital Anxiety and Depression Scale(HADS)scores were significantly lower than those in the control group(P<0.01 or P<0.05).The incidence of pulmonary infection and venous thrombosis in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Trimodal pre-rehabilitation nursing intervention can effectively improve the perioperative nutritional status and psychological state of patients with pancreaticoduodenectomy,improve their quality of life and reduce the incidence of complications.

关 键 词：三联预康复 策略 胰腺癌 胰十二指肠 切除术 康复 

分 类 号：R574.51[医药卫生—消化系统] R493[医药卫生—内科学] R473.6[医药卫生—临床医学]