早期目标导向活动方案对胰腺肿瘤切除术后患者活动的影响  

Effects of early goal-directed mobilization protocols on the activity of patients after pancreatic tumor resection

作　　者：姚晖[1] 段晓磊 高雯晴 刘佳楠 姚文洁 张贇 杨富[1] 方芳[1] YAO Hui;DUAN Xiaolei;GAO Wenqing;LIU Jianan;YAO Wenjie;ZHANG Yun;YANG Fu;FANG Fang(Pancreatic Surgery,Shanghai General Hospital,Shanghai,200080,China)

机构地区：[1]上海市第一人民医院护理部,上海市200080

出　　处：《中国护理管理》2024年第5期713-718,共6页Chinese Nursing Management

基　　金：上海交通大学医学院科技基金(Jyhz2118);复旦大学循证护理中心证据转化与临床应用项目(Fudanebn202339);上海市第一人民医院特色研究项目(CCTR-2022N05)。

摘　　要：目的:分析早期目标导向活动方案在胰腺肿瘤切除术后患者中的临床应用效果,以期提高患者术后早期活动的有效性及主动性,促进患者术后康复。方法:随机选取2023年3月—5月在上海市某三级甲等医院完成胰腺手术的35名患者为对照组,2023年6月—8月的35名患者为实验组。对照组采取胰腺肿瘤切除术后常规护理措施,实验组除采取常规护理,在督促患者早期下床活动方面应用早期目标导向活动方案。对比两组患者术后首次下床、肛门排气、排便、经口饮水、导尿管拔除及胃管拔除时间来评价方案有效性;对比两组患者术后并发症及活动相关不良事件发生情况来评价方案安全性。结果:两组患者首次下床、肛门排气、排便、经口饮水时间差异有统计学意义(P<0.05),导尿管拔除、胃管拔除时间及术后并发症发生情况差异无统计学意义(P>0.05),两组患者均未发生活动相关不良事件。结论:早期目标导向活动方案对促进胰腺肿瘤切除术后患者早下床、早经口饮水、术后排气和排便方面是安全、有效的,且不增加术后出血、非计划拔管、死亡等风险。Objective:To analyze the clinical application effect of early goal-directed mobilization protocols in patients after pancreatic tumor resection,in order to improve the effectiveness and initiative of early activity and promote postoperative recovery of patients.Methods:We randomly selected 35 patients who underwent pancreatic surgery at a tertiary grade A hospital in Shanghai from March to May 2023 as the control group,and 35 patients from June to August 2023 as the experimental group.The control group was treated with routine nursing measures after pancreatic tumor resection,and the experimental group applied the early goal-directed mobilization protocols in supervising the early activities of the patients.The effectiveness of the protocol was evaluated by comparing the time of first getting out of bed,flatus,defecation,oral drinking,urinary catheter removal and gastric tube removal between the two groups.The occurrence of postoperative complications and activity-related adverse events were compared between the two groups to evaluate the safety of the protocol.Results:There were statistically significant differences in the time of first getting out of bed,flatus,defecation and oral drinking between the two groups(P<0.05).There were no significant differences in urinary catheter removal time,gastric tube removal time and postoperative complications between the two groups(P>0.05).No exercise-related adverse events were observed in either group.Conclusion:Early goal-directed mobilization protocols is safe and effective in promoting early ambulation,early drink oral water and postoperative ventilation and defecation after surgery,no increased risk of postoperative bleeding,unplanned extubation and death.

关 键 词：胰十二指肠切除术 胰体尾切除术 全胰切除术 早期目标导向活动 循证实践 加速康复外科 

分 类 号：R47[医药卫生—护理学] R197[医药卫生—临床医学]