基于5A模式的围术期早期康复在复发性肝癌腹腔镜肝切除术联合微波消融术的应用效果

Application effect of early perioperative rehabilitation based on 5A model in laparoscopic hepatectomy combined with microwave ablation for recurrent liver cancer

目的探讨基于5A模式的围手术期早期康复在复发性肝癌腹腔镜肝切除术联合微波消融术的应用效果。方法选取该院2018年7月至2021年7月收治的复发性肝癌患者97例,按随机数字分为康复组(53例)和对照组(54例),比较两组症状评估、自我效能、情绪变化、生活质量。结果干预前两组患者记忆症状评估量表(MSAS)总评分无统计学差异;干预后两组患者MSAS总评分均低于干预前,且康复组MSAS总评分低于对照组,差异有统计学意义(P<0.05)。干预前两组患者自我效能量表(GSES)总评分无统计学差异;干预后两组患者GSES总评分均高于干预前,且康复组GSES总评分高于对照组,差异有统计学意义(P<0.05)。干预前两组患者简明心境状态量表(POMS)中疲劳、慌乱、愤怒、抑郁、紧张分值无统计学差异;干预后两组患者疲劳、慌乱、愤怒、抑郁、紧张分值均低于干预前,且康复组疲劳、慌乱、愤怒、抑郁、紧张分值均低于对照组,差异有统计学意义(P<0.05)。干预前两组患者健康调查简表(SF-36)各项评分无统计学差异;干预后两组患者SF-36各项评分均高于干预前,且康复组SF-36各项评分均高于对照组,差异有统计学意义(P<0.05)。结论基于5A模式的围手术期早期康复在复发性肝癌腹腔镜肝切除术联合微波消融术中的应用效果良好,减轻了患者症状困扰和不良情绪,提高了患者自我护理能力和生活质量。

Objective:To explore the application effect of perioperative early rehabilitation based on 5A model in laparoscopic hepatectomy combined with microwave ablation for recurrent liver cancer.Methods:A total of 97 patients with recurrent liver cancer admitted to this Hospital from July 2018 to July 2021 were selected and divided into rehabilitation group(n=53)and control group(n=54)according to the random number table method.Symptoms,self-efficacy,emotion changes and quality of life of the two groups were compared.Results:There were no statistically significant difference in the memory symptom assessment scale(MSAS)scores and general self efficacy scale(GSES)scores between the two groups before intervention(P>0.05).After intervention,the MSAS scores of the two groups were reduced(P<0.05),and the GSES scores were increased(P<0.05).Meanwhile,the rehabilitation group had lower MSAS scores and higher GSES scores than the control group(P<0.05).There was no significant difference in the scores of fatigue,panic,anger,depression,and tension in profile mood states(POMS)of the two groups before intervention(P>0.05).After intervention,the scores of the two groups were reduced(P<0.05),and the rehabilitation group had lower than the control group(P<0.05).There was no statistically significant difference in the MOS 36-Item Short-Form Health Survey(SF-36)scores between the two groups before intervention(P>0.05).After intervention,the SF-36 scores of the two groups were increased(P<0.05),and the rehabilitation group had higher scores than the control group(P<0.05).Conclusions:Early perioperative rehabilitation based on 5A model can achieve good effect in laparoscopic hepatectomy combined with microwave ablation for recurrent liver cancer,which relieves the patients′symptoms and unhealthy emotions,and improves their self-care ability and quality of life.