基于院前住院管理平台的预康复理念在机器人辅助腹腔镜肾肿瘤手术中的应用

Application of Pre-rehabilitation Concept Based on the Pre-hospitalization Center Management System in Robot-assisted Laparoscopic Renal Tumor Surgery

目的探讨基于院前住院管理平台的预康复理念在机器人辅助肾肿瘤手术中的应用价值。方法选择我院2020年10月~2021年6月机器人辅助腹腔镜肾肿瘤手术182例,按入院顺序单双号分为预康复组与对照组各91例。2组年龄、性别、ASA分级、BMI、肿瘤部位、合并癌栓情况差异均无统计学意义(P>0.05)。预康复组入院前经住院管理平台接受心理、营养和运动能力评估和干预,对照组围术期接受传统泌尿外科护理。比较2组术后首次下地时间、排气时间、术后住院时间、患者住院满意度。结果预康复组预康复干预时间6~20 d,(10.1±3.2)d,干预后心理状况和下肢活动能力明显改善(P<0.05)。预康复组首次下地早[(15.5±3.0)h vs.(17.2±3.8)h,t=-3.468,P=0.001],排气早[(26.0±6.7)h vs.(28.9±8.2)h,t=-2.624,P=0.009],术后住院时间短[(4.7±0.9)d vs.(5.5±1.0)d,t=-5.537,P=0.000],患者满意度评分高[(9.99±0.03)分vs.(9.95±0.09)分,t=3.673,P=0.000]。结论基于院前住院管理平台的预康复理念干预对机器人辅助腹腔镜肾肿瘤手术康复效果良好,促进患者术后快速恢复,缩短术后住院时间。

Objective To explore the influence of pre-rehabilitation concept based on the Pre-hospitalization Center Management System in rehabilitation effect in patients undergoing robot-assisted laparoscopic renal tumor surgery.Methods From October 2020 to June 2021,182 patients treated with robot-assisted laparoscopic surgery were divided into either pre-rehabilitation group or control group according to the convenient grouping method,with 91 cases in each group.There were no significant differences in age,sex,American Society of Anesthesiologists(ASA)classification,body mass index(BMI),tumor location,or tumor thrombus between the two groups(P>0.05).The patients in the pre-rehabilitation group received pre-rehabilitation concept psychological,nutritional and sports ability evaluation and intervention through the Pre-hospitalization Center Management System before admission,while the patients in the control group received traditional urological nursing intervention during perioperative period.The first time to the ground,recovery time of intestinal peristalsis,postoperative hospital stay,and patients’satisfaction with hospitalization were compared between the two groups.Results The intervention time in the pre-rehabilitation group was 6-20 d[(10.1±3.2)d].After the intervention,the psychological status and lower limb activity were significantly improved(P<0.05).As compared to the control group,the pre-rehabilitation group had earlier first time to the ground[(15.5±3.0)h vs.(17.2±3.8)h,t=-3.468,P=0.001],earlier recovery time of intestinal peristalsis[(26.0±6.7)h vs.(28.9±8.2)h,t=-2.624,P=0.009],shorter hospital stay[(4.7±0.9)d vs.(5.5±1.0)d,t=-5.537,P=0.000],and higher patient satisfaction scores[(9.99±0.03)points vs.(9.95±0.09)points,t=3.673,P=0.000].Conclusion The pre-rehabilitation concept intervention based on the Pre-hospitalization Center Management System has a good effect on the rehabilitation in patients with robot-assisted laparoscopic renal tumor surgery,promotes the rapid recovery of patients,and shortens the postoperative hospital stay.