摘要
目的 探讨围手术期全程肺康复训练对预防老年肝叶切除患者术后肺部并发症(PPCs)的效果。方法 选取2020年8月至2021年6月在四川大学华西医院胆道外科行肝叶切除的老年患者78例作为研究对象,采用电脑产生随机数字,将患者随机分成对照组和试验组,每组各39例。对照组采用常规肺康复训练,试验组在常规肺康复训练基础上给予以护士为主导的围手术期全程肺康复训练计划和方案。对比分析两组患者PPCs发生率、术后首次下床活动时间、术后肛门排气时间、住院天数及非计划再入院发生率等康复指标。结果 最终77例患者纳入研究分析,其中试验组39例,对照组38例。试验组PPCs总体发生率低于对照组(P<0.05),但两组肺部感染、胸腔积液、肺不张发生率比较差异无统计学意义(P>0.05);试验组术后首次下床活动时间、术后肛门排气时间、术后住院时间均低于对照组(P<0.05),但两组平均住院天数、术后30 d非计划性再入院发生率比较差异无统计学意义(P>0.05)。结论 围手术期全程肺康复训练可降低老年肝叶切除患者PPCs的发生率,促进术后快速康复,缩短术后住院天数。
Objective To investigate the effect of perioperative whole-course pulmonary rehabilitation training on the prevention of postoperative pulmonary complications(PPCs)in elderly patients undergoing hepatectomy.Methods A total of 78 elderly patients who underwent hepatectomy in the bilary surgery department of West China Hospital of Sichuan University from August 2020 to June 2021 were included as the research objects.They were divided into control group(n=39)and experimental group(n=39)by random number method.The control group was given routine pulmonary rehabilitation training,while the experimental group was given nurse-supervised perioperative whole-course pulmonary rehabilitation training on the basis of routine pulmonary rehabilitation.The incidence of PPCs,the time to get out of bed for the first time after surgery,the time of postoperative anal exhaust,the length of hospital stay,and the rate of unplanned readmission were compared between the two groups.Results Eventually,77 patients were included in the study,including 39 in the experimental group and 38 in the control group.The overall incidence of PPCs in the experimental group was lower than that in the control group(P<0.05),but there was no significant difference in the incidence of postoperative pulmonary infection,pleural effusion,atelectasis,and pulmonary embolism between the two groups(P>0.05).The time to get out of bed for the first time after surgery,the time of postoperative anal exhaust,and the length of postoperative hospital stay in the experimental group were all lower than those in the control group(P<0.05).However,there was no significant difference in the average length of hospital stay and the incidence of unplanned readmission within 30 days after surgery between the two groups(P>0.05).Conclusion Perioperative whole-course pulmonary rehabilitation training can reduce the incidence of PPCs in elderly patients undergoing hepatectomy,promote their rapid recovery after surgery,and shorten their postoperative hospital stay.
作者
韩蔷
许瑞华
冯金华
高敏
曾婷
凌元春
Han Qiang;Xu Ruihua;Feng Jinhua;Gao Min;Zeng Ting;Ling Yuanchun(Department of Bilary Surgery,West China Hospital,Sichuan University,Chengdu 610041,China;West China School of Nursing,Sichuan University,Chengdu 610041,China)
出处
《成都医学院学报》
CAS
2023年第3期325-328,348,共5页
Journal of Chengdu Medical College
基金
国家科技部重点研发项目(No:2018YFC2001805-2)
四川省科技厅支撑项目(No:2021YFS0153,No:22KJPX0146)。
关键词
全程肺康复训练
老年患者
肝叶切除
术后肺部并发症
Whole-course pulmonary rehabilitation training
Elderly patient
Hepatectomy
Postoperative pulmonary complication
