基于证据的结直肠癌患者围手术期早期活动方案构建及效果评价  

Construction and Effect Evaluation of an Evidence-based Early Perioperative Ambulation Plan for Colorectal Cancer Patients

作　　者：岳莺 顾艳荭 雷卫爱[1,2] 胡德雪 汪莉莉 YUE Ying;GU Yanhong;LEI Weiai;HU Dexue;WANG Lili(Shanghai Fifth People's Hospital,Fudan University,Shanghai 200040;Center of Community-based Health Research,Fudan University,Shanghai 200040;School of Nursing Fudan University,Shanghai 200240)

机构地区：[1]复旦大学附属上海市第五人民医院,上海200040 [2]复旦大学社区健康研究中心,上海200040 [3]复旦大学护理学院,上海200240

出　　处：《上海护理》2025年第3期17-23,共7页Shanghai Nursing

基　　金：上海市闵行区自然科学研究课题(2021MHZ038);复旦大学-复星护理科研基金项目(FNF202161)。

摘　　要：目的构建基于证据的结直肠癌患者围手术期早期活动方案,并评价其效果。方法在循证实践的基础上进行结直肠癌围手术期早期活动的最佳证据应用,观察证据应用后审查指标的达标情况。采用方便抽样方法选取2023年4-9月在上海市某三级医院行结直肠肿瘤切除术的84例患者作为研究对象。根据入院时间将其分为对照组(n=42)和观察组(n=42)。对照组术后接受常规护理活动管理,观察组在对照组基础上采用基于证据的结直肠肿瘤手术患者早期活动方案进行干预。比较两组患者术后早期活动依从性、恢复情况、活动能力及并发症发生率。结果观察组术后早期活动依从性(73.8%)、首次下床活动时间[(43.14±4.06)h]、首次肛门排气时间[(55.21±6.77)h]、住院天数[(9.79±1.72)d]、下床活动水平得分[(43.14±4.06)分]、锻炼自我效能得分[(26.86±3.02)分]、并发症发生率(4.76%)均优于对照组(P<0.05)。结论基于证据的围手术期早期活动方案能促进结直肠癌患者术后康复并改善临床结局,值得推广。Objective To construct an evidence-based early perioperative ambulation plan for colorectal cancer patients and evaluate its effects.Methods Based on evidence-based practice,the best evidence of early perioperative ambulation for colorectal cancer was applied to observe whether the set indicators were achieved after the application.A total of 84 patients who underwent colorectal tumor resection from April to September 2023 in a tertiary hospital in Shanghai were selected by convenience sampling.They were divided into the control group(n=42)and the observation group(n=42)according to the time of admission.For those patients undergoing colorectal tumor surgery,the control group was given routine postoperative ambulation care whereas the observation group was intervened with an evidence-based early ambulation plan.The early postoperative ambulation compliance,recovery,mobility and incidence of complications were compared between the two groups.Results In the observation group,the early postoperative ambulation compliance was 73.8%,the time to first ambulation was(43.14±4.06)h,the time to first anal exhaust was(55.21±6.77)h,the length of hospital stay was(9.79±1.72)d,the score of ambulation was(43.14±4.06)points,the score of exercise self-efficacy was(26.86±3.02)points and the incidence of complications was 4.76%;these results were all superior to those in the control group(P<0.05).Conclusion This evidencebased early perioperative ambulation plan is worthy of promotion as it can promote postoperative rehabilitation and improve clinical outcomes in patients with colorectal cancer.

关 键 词：结直肠肿瘤 围手术期 早期活动 循证方法 效果评价 

分 类 号：R473.73[医药卫生—护理学] R473.6[医药卫生—临床医学]