运动处方在腹腔镜肾部分切除术患者围术期康复中的应用探讨

Perioperative exercise prescription in recovery of patients undergoing laparoscopic partial nephrectomy

  • 摘要: 目的 探讨运动处方在腹腔镜肾部分切除术患者围术期康复中的应用效果。 方法 选取本院泌尿外科2016年2-6月行腹腔镜肾部分切除术的患者79例,将其随机分为运动处方组和常规组。常规组按照泌尿外科围术期常规方法处理;运动处方组引入"运动处方"理念,由康复科医生、泌尿外科医生及护士组成康复小组,制订患者的运动处方,并监督患者执行。比较两组患者的术后恢复情况、术后住院日和自理能力恢复情况。 结果 常规组42例,男性29例,女性13例,年龄(53.93±13.12)岁;运动处方组37例,其中男性25例,女性12例,年龄(50.54±12.73)岁;两组患者的年龄、性别、体质量指数、腹腔镜入路和手术部位差异均无统计学意义异(P均> 0.05)。患者的首次排气时间和首次排便时间运动处方组分别为(30.24±8.20) h和(2.70±1.05) d,常规组为(42.59±7.15) h和(3.74±0.77) d,运动处方组均显著早于常规组(P均< 0.05)。患者术后第2天腹胀发生率运动处方组为35.14%,常规组为59.52%;术后平均住院日运动处方组为(4.35±1.95) d,常规组为(5.33±1.56) d;术后第3天日常生活自理能力量表评分运动处方组为45.86±5.50,常规组为54.48±6.75,运动处方组均明显低于常规组(P均< 0.05)。 结论 运动处方在腹腔镜肾部分切除术患者围术期康复中的应用,可促进患者术后胃肠功能恢复,缩短术后住院日,加速患者术后日常生活自理能力的恢复。

     

    Abstract: Objective To discuss the effect of exercise prescription on recovery of patients undergoing laparoscopic partial nephrectomy. Methods Totally 79 patients who underwent laparoscopic partial nephrectomy from February to June in 2016 in Chinese PLA General Hospital were included, and they were randomly divided into two groups, exercise prescription group and traditional education group. In traditional education group, routine health education was performed; while in exercise prescription group, exercise prescription was introduced, and the content of exercise prescription was constructed and performed by the rehabilitation team consisting of rehabilitation doctor, urologist and nurse. Post-operative recovery outcomes were compared between two groups. Results There were 42 cases in traditional education group with 29 males and 13 females, with an average age of (53.93±13.12) years, and 37 cases in exercise prescription group with 25 males and 12 females, with an average age of(50.54±12.73) years. There was no statistically significant difference in age, sex, BMI, surgical approach and side of operation between two groups. However, anal exhaust time and defecating time of patients in exercise prescription were shorter than those of patients in traditional education group (30.24±8.20) h vs (42.59±7.15) h, (2.70±1.05) d vs (3.74±0.77) d, P< 0.05, respectively. The rate of abdominal distension on the second day after operation, the mean post-operative hospital stay and ADL score on the third day in exercise prescription group were all significantly lower or shorter than those of traditional group 35.14% vs 59.52%, (4.35±1.95) d vs (5.33±1.56) d, (45.86±5.50) vs (54.48±6.75), all P< 0.05. Conclusion Application of exercise prescription in patients undergoing laparoscopic partial nephrectomy during the perioperative period can improve the recovery of gastrointestinal function after operation, shorten the post-operative hospital day and accelerate the regain of self-care ability.

     

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