早期床上抗阻运动对胃肠道肿瘤患者术后康复护理的影响

doi:10.3761/j.issn.0254-1769.2023.12.008

摘要/Abstract

摘要：

目的探讨早期床上抗阻运动对胃肠道肿瘤患者术后康复护理的影响。方法采用方便抽样法，选取2021年1月—12月在上海市某三级甲等医院胃肠外科接受胃肠道肿瘤手术治疗的150例患者作为研究对象，采用随机数字表法将患者分为试验组74例和对照组76例，试验组给予术后早期床上抗阻运动方案，对照组给予术后早期离床活动方案，在干预后分别比较两组疼痛评分、惯用手握力、消化道功能恢复时间、导管留置时间、术后住院时间、住院费用的差异，并评价抗阻运动的安全性。结果试验组干预后惯用手握力增加，差异具有统计学意义（P=0.017）；对照组首次排气时间早于试验组，差异具有统计学意义（P=0.032）；两组术后疼痛评分、导管留置时间、住院天数、住院费用比较，差异均无统计学意义（P>0.05）；试验组在运动后心率波动的患者例数与体力不支的患者例数少于对照组，差异均具有统计学意义（P<0.05），且在活动中未发生严重不良事件。结论早期床上抗阻运动可以增加胃肠道肿瘤术后患者的肌肉力量；降低早期活动后心率波动及乏力的症状，可以促进胃肠道肿瘤患者术后康复。

关键词: 胃肠道肿瘤, 抗阻运动, 早期活动, 快速康复, 护理

Abstract:

Objective To investigate the effect of early bed resistance exercise on postoperative rehabilitation in patients with gastrointestinal tumors. Methods By random sampling of experimental study design，150 patients who received gastrointestinal tumor surgery were selected from a tertiary A hospital in Shanghai during January to December 2021. The random number table method was employed to divide them into a test group with 74 cases and a control group with 76 cases. The test group received the postoperative early bed resistance exercise. The control group was given the early postoperative ambulation protocol. The differences in pain score，dominant hand grip strength，time to recovery of digestive tract function，catheter retention time，postoperative hospitalization time after the intervention were compared，and the safety of resistance exercise was evaluated. Results In the postoperative rehabilitation index of the 2 groups，the increase in dominant hand grip strength after the intervention was greater than that before the intervention（P=0.017）；the first exhaust time in the control group was earlier than that in the test group（P=0.032）；the remaining indicators included postoperative pain scores，catheter indwelling time，hospital days，hospitalization costs in both groups，and the differences were not statistically significant（P>0.05）. The number of patients with heart rate fluctuation after exercise and those with physical exhaustion was less than that of the control group，and all the differences were statistically significant（P<0.05），and no serious personal injury or serious adverse events occurred during the activities. Conclusion Early bed resistance exercise can increase muscle strength after gastrointestinal tumors，reduce heart rate fluctuation and fatigue after early activity and pro-mote postoperative recovery of gastrointestinal tumors.

Key words: Gastrointestinal Tumor, Resistance Exercise, Early Activity, Rapid Recovery, Nursing Care

顾一帆, 吴茜, 汪夏云, 周杰. 早期床上抗阻运动对胃肠道肿瘤患者术后康复护理的影响[J]. 中华护理杂志, 2023, 58(12): 1462-1468.

GU Yifan, WU Qian, WANG Xiayun, ZHOU Jie. Effect of early bed resistance exercise on postoperative rehabilitation in patients with gastrointestinal tumors[J]. Chinese Journal of Nursing, 2023, 58(12): 1462-1468.

图/表 5

表1 两组一般资料比较

Table 1 Comparison of general data in 2 groups

表2 两组活动时疼痛评分比较[分，M（P25，P75）]

Table 2 Comparison of pain scores during activity in 2 groups[score，M（P25，P75）]

表 3 两组干预前后惯用手握力指标比较（kg，

\bar{x} \pm s

）

Table 3 Comparison of dominant hand grip strength index in 2 groups before and after intervention（kg，

\bar{x} \pm s

）

表 3 两组干预前后惯用手握力指标比较（kg， $\bar{x} \pm s$ ）

Table 3 Comparison of dominant hand grip strength index in 2 groups before and after intervention（kg， $\bar{x} \pm s$ ）

表4 两组康复指标比较[M（P25，P75）]

Table 4 Comparison of rehabilitation indicators in 2 groups[M（P25，P75）]

表5 两组运动干预安全性评价比较[例（百分率，%）]

Table 5 Evaluation of intervention safety in 2 groups[case（pencentage，%）]

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