大肠癌患者术后首次下床时间及其相关因素

First Time of Getting out of the Bed and Its Relative Factors in Postoperative Patients with Colorectal Cancer

目的调查大肠癌患者术后首次下床时间并分析其相关因素，以期为制定个体化的术后早期下床活动计划提供依据。方法便利抽样法选取2011年6—12月在北京某三级甲等医院普通外科住院的80例大肠癌患者为研究对象，采用自行设计问卷对其进行调查，主要包括、性别、年龄、文化程度、婚姻状况、疾病情况、体质量指数（body mass index，BMI）、患病时间、卡式评分（Karnofsky performance scale，KPS）、体重是否变化、术前营养指标（血红蛋白、白蛋白、前白蛋白）、手术方式、手术时间、术后病理分级、术后镇痛方式、术后首次下床时间等，并分析上述指标与术后首次下床时间的关系。结果80例大肠癌患者术后首次下床时间平均为术后（45．46±23．48）h。术后24-48h下床者最多，共31例，占38．8％。年龄大（F=6．45，P=0．003）、KPS评分低（t=3．884，P=0．000）、术前前白蛋白低（t=2．748，P=0．007）和血红蛋白低（t=3．407，P=0．030）的患者术后首次下床时间较晚。结论大肠癌患者术后首次下床时间有个体差异，可根据大肠癌患者临床特征决定尽可能早的术后首次下床时间，并进行连续性监督和指导。

Objective To survey and analyze the first time of getting out of the bed and its relative factors in postoperative patients with eolorectal cancer, so as to provide evidences for making individualized activi- ties plan for getting out of bed in early period after operation. Methods A total of 80 patients with colorectal cancer were recruited and assessed by self-designed questionnaires, which included sexuality, age,education level, height, marital status, time for admission, disease situation, body mass index, sick time,Karnofsky performance scale, weight, preoperative nutritional indicators （preoperative hemoglobin values, preoperative albumin values, preoperative prealbumin values） , operation type and time, analgesic way, postoperative pathologic stage, time back to the ward, and first time of getting out of the bed. Results The mean hours of the first time of getting out of the bed were 45.46±23.48 hours, when 31 participants（38.8%）leaving bed in 24-48 hours postoperation. The time of first leaving bed was longer when patients were older（F=6.45 ,P=0. 003） ,with lower preoperative KPS score（t=3. 884,P=0. 000）, with preoperative PA decreasing （t = 2. 748, P = 0. 007） and HGB decreasing （t = 3. 407, P = 0. 030）. Conclusion The results show that the time of first leaving bed after operation is different. It is suggested that upright mobilization should be encouraged as early as possible, considering patients＇ clinical charac- teristics, supervision and guidance should be performed continuously.