三联预康复策略在下肢外周动脉疾病围术期患者的应用及效果评价

Application and effect evaluation of trimodal prehabilitation strategy in perioperative patients with peripheral arterial disease of lower extremity

目的探讨三联预康复策略在下肢外周动脉疾病围术期患者的应用效果。方法选取2018年6月-2019年6月本院血管外科收治的90例需择期在全麻下行下肢动脉探查手术的患者作为研究对象。根据入院时间先后顺序,选取2018年6-12月收治本院血管外科的45例患者作为对照组,2019年1-6月收治的45例患者作为观察组。对照组采用围手术期护理常规进行护理干预,观察组采用三联预康复策略进行护理干预。比较患者术前及术后6 min步行距离、抑郁状态、营养状态、并发症发生率、住院天数等。结果6 min步行距离术前1 d、术后1周观察组高于对照组;观察组术后抑郁程度较对照组程度减轻;术前及术后营养指标高于对照组;术后并发症发生率和住院天数低于对照组,各项指标差异均有统计学意义(P<0.05)。结论对下肢外周动脉疾病患者术前实施三联预康复措施能改善患者术后运动功能和营养状况,调节患者负性情绪,提高患者手术应激能力,从而促进患者术后康复,缩短住院时长。

Objective To study the Applying effect of trimodal prehabilitation strategy in perioperative patients with lower extremity arterial disease(LE-PAD).Methods From June 2018 to June 2019,90 patients who needed selective arterial exploration under general anesthesia were selected as the research objects.According to the order of admission time,from June 2018 to December 2018,45 patients admitted to the vascular surgery department of our hospital were selected as the control group,and from January 2019 to June 2019,45 patients were selected as the observation group.The control group was given routine nursing intervention during perioperative period,while the observation group was given trimodal prehabilitation strategy.6 min walking test(6MWT),degree of depression,the nutritional status,complication rate and hospitalization days were compared before and after operation.Results 6MWT was higher in the observation group than that in the control group one day before and one week after the operation(P<0.05);the degree of depression in the observation group was lighter than that in the control group;the preoperative and postoperative nutritional indexes were higher than those in the control group;the incidence of postoperative complications and hospitalization days were lower than those in the control group,The difference was statistically significant(P<0.05).Conclusion The patients with peripheral arterial disease of lower limbs were treated with trimodal prehabilitation measures before operation,can significantly improve the preoperative and postoperative motor function and nutritional status of patients,regulate the negative emotions of patients,improve the ability of patients to cope with surgery,so as to promote postoperative rehabilitation and shorten the length of hospital stay.