肝癌术后早期下床活动方案的构建及应用
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女,本科,副主任护师

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国家临床重点专科建设项目(苏卫转[2011]99号);南京大学医学院附属鼓楼医院院内护理科研项目(SB175-2)


Development and application of evidence-based practice protocol for early mobilization after liver cancer surgery
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    目的 制订肝癌术后早期下床活动方案,探讨实施效果。方法 按照入院时间将93例肝癌行肝切除术患者分为对照组45例和观察组48例。对照组实施术后常规活动护理;观察组实施早期下床活动循证实践方案,通过检索数据库获取最佳证据及整合证据,制定肝癌术后早期下床活动实践方案及流程。结果 观察组术后24 h内下床活动率、首次下床时间及术后活动量指标显著优于对照组,术后排气排便时间、胃管留置时间显著短于对照组,术后24 h疼痛评分、疼痛控制满意度显著优于对照组(P<0.05,P<0.01);两组早期活动不良事件发生率比较,差异无统计学意义(P>0.05)。结论 肝癌术后早期下床活动最佳实践方案的实施,可加快肝癌患者术后康复,促进患者安全(并不增加患者安全事件)。

    Abstract:

    Objective To develop early mobilization protocol for liver cancer patients and to explore the application effect. Methods Ninety-three patients with liver cancer undergoing hepatectomy were assigned to a control group of 45 and an intervention group of 48 according to their admission time. The control group was given routine mobilization, while the intervention group was subjected to early mobilization program: the best evidence was retrieved and integrated to develop an evidence-based early mobilization protocol, then work process was revised.Results The intervention group had higher incidence of out-of-bed activity within postoperative 24 h, earlier out-of-bed mobilization, better postoperative activity performance, earlier flatus and defecation, shorter gastric tube indwelling time, lower pain intensity and higher satisfaction with pain control compared with the control group (P<0.05, P<0.01). Adverse events during mobilization had no significant difference between the two groups (P>0.05).Conclusion Implementation of evidence-based early mobilization practice protocol for liver cancer surgery can boost recovery of patients without increa-sing safety events.

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何宁宁,周利平,薛冰,王清,冯丽,任昊桢,施晓雷,陆巍.肝癌术后早期下床活动方案的构建及应用[J].护理学杂志,2020,35(1):24-28

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  • 收稿日期:2019-08-02
  • 最后修改日期:2019-10-08
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  • 在线发布日期: 2022-09-06