量化式目标锻炼对食管癌患者微创术后快速康复的效果观察

目的 探讨食管癌患者微创术后应用量化式目标锻炼对康复速度和质量的影响。 方法 选取中国人民解放军海军总医院2015年10月-2017年11月行食管癌微创切除术的患者244例,采用随机数字表法分为观察组和对照组各122例,对照组患者术后采取常规护理措施,观察组在常规护理措施的基础上实施量化式目标锻炼。比较2组患者术后下床活动时间及日活动总量、术后康复情况(胃管拔除时间、排气时间、有关并发症的发生率)及住院时间。 结果 观察组和对照组患者在24 h内分别有86例和46例开始下床活动,观察组患者下床时间略早于对照组(P<0.05);观察组在24 h内、24~36 h、>36 h后这3个观察期间的活动时间也高于对照组(P<0.05);术后第1、2、3、4、5天的日活动总量观察组均不同程度高于对照组(P<0.05);观察组的胃管拔除时间是(58.0±14.8)h早于对照组的(69.0±12.6)h,差异有统计学意义(P<0.05),2组术后排气时间分别是(39.9±17.5)h和(44.8±15.6)h,观察组早于对照组(P<0.05);观察组并发症的发病率(10.65%)低于对照组(19.67%)观察组住院时间(10.6±1.2)d,短于对照组(11.7±1.3)d,差异有统计学意义(P<0.05)。 结论 微创食管癌切除术后患者采用量化式目标锻炼,可加快患者康复速度、提高康复质量,并缩短住院时间。 

Effect of quantitative exercise on patients with esophageal cancer after minimally invasive esophagectomy

Objective To explore the effect of quantitative exercise on recovery speed and recovery quality of patients with esophageal cancer after minimally invasive esophagectomy. Methods A total of 244 esophageal cancer patients who underwent minimally invasive resection in our hospital from October 2015 to November 2017 were collected, and divided randomly and equally into observation group and control group. Patients in control group adopted routine nursing measures and patients in observation group adopted quantitative exercise besides routine nursing measures. Out-of-bed activity time, daily amount of exercise, rehabilitation assessment (the removal time of gastric tuber, intestinal exhaust time, the incidence of post-surgery complications) and post-surgery hospitalization duration. Results A total of 86 cases in observation group and 46 cases in control group had out-of-bed activity in 24 h post surgery, and out-of-bed activity time of patients in observation group is slightly earlier than that in control group (P<0.05). The same results were observed in the amount of out-of-bed activity of 24 h, 24-36 h and >36 h post surgery (P<0.05). The amount of out-of-bed activity of patients in observation group each day during the first five days post surgery were significantly higher than that in the control group (P<0.05). The gastric tuber detaining time of patients in observation group was shorter than that of patients in control group (58.0±14.8) h vs. (69.0±12.6) h, P<0.05]. The same condition was observed on intestinal exhaust time (39.9±17.5) h vs. (44.8±15.6) h, P<0.05] and hospitalization time (10.6±1.2) h vs. (11.7±1.3) h, P<0.05]. The incidence of complications in observation group was lower than that in the control group (10.65% vs. 19.67%, P<0.05). Conclusion Quantitative exercise could accelerate the recovery rate, improve the rehabilitation quality and shorten the length of stay of patients after minimally invasive esophagectomy, and could be applied to clinical practice.