肝切除术后患者早期活动的最佳证据应用

目的 基于肝切除术后患者早期活动的最佳证据总结,构建基于证据的质量审查指标,分析影响术后早期活动的主要障碍因素并实施相应的对策。 方法 开展全员培训与考核,建立每日活动目标并制订标准化作业流程,加强术前宣教,选择最佳活动时机,开展术后活动性疼痛评估,增添安全型活动辅助工具,调动患者离床活动的意愿和积极性,定期系统性地审核护理措施实施后的依从性和临床结果。 结果 医护人员对最佳证据的知晓率提高,患者术后首次下床活动时间提前,每日活动目标达成率提高,首次肛门排气时间提早,干预前后差异均有统计学意义（P<0.001）;活动性疼痛评分≥4分的发生率降低,干预前后差异有统计学意义（P<0.05）。 结论 肝切除术后患者早期活动的最佳证据应用,能有效兼顾患者安全与快速康复。

Implementation of best evidence on early mobilization among patients after liver resection

Objective Based on best evidence summary on early mobilization among patients after liver resection, evidence-based quality examination criteria were established, and barrier factors for early mobilization after liver resection were analyzed and corresponding countermeasures were implemented. Methods Carry out the training and examination for all medical staff, set up goals for daily activities and standard operating procedure, strength preoperative education, choose the best timing for early mobilization, assess postoperative pain during activities dynamically, use self-oriented assistant equipment, encourage patients to leave the beds, systematically and regularly review the compliance and clinical results. Results The countermeasures were able to improve knowledge in medical staff, make an earlier mobilization after surgery in patients, improve the completion rate of daily activities, make an earlier initial anal exhaust, decrease the incidence of severe pain（pain scored≥4）. Conclusion Evidence-based practice ensure a safe and rapid recovery.