基于多学科协作院前预康复策略在食管癌患者中的应用

目的探讨基于多学科协作的院前预康复策略在食管癌患者中的应用效果。方法选取2020年7月至2021年12月本科收治的60例食管癌患者为研究对象,用随机数字表法将其分为对照组及观察组,每组各30例。对照组行常规术前准备,观察组在对照组基础上实施多学科协作院前预康复策略。比较两组首次就诊日、术前1 d、术后7 d,6MWD、焦虑筛查量表(GAD-7)、抑郁筛查量表(PHQ-9)得分、营养相关指标(白蛋白、前白蛋白)、术后并发症发生情况及术后住院天数。结果观察组术前1 d、术后7 d,6MWD均优于对照组(P<0.05),差异有统计学意义;观察组术前1 d,GAD-7、PHQ-9得分低于对照组(P<0.05),差异有统计学意义;术后7 d观察组血白蛋白及前白蛋白高于对照组(P<0.05),差异有统计学意义;观察组术后住院天数[(16.00±5.66)d]低于对照组[(20.03±5.52)d](P<0.05)。结论基于多学科协作的院前预康复策略有利于增强食管癌患者围手术期活动耐力,减轻其心理负担,改善其营养状况,进而促进患者术后康复。

Objective To explore the application effect of pre-hospital rehabilitation strategy based on multidisciplinary collaboration in patients with esophageal cancer.Methods 60 patients with esophageal cancer admitted to our department from July 2020 to December 2021 were selected as the research objects,and they were divided into a control group and an observation group randomly,with 30 cases in each group.The control group underwent routine preoperative preparation,and the observation group implemented a multidisciplinary pre-hospital rehabilitation strategy on the basis of the control group.And then 6MWD,the scores of GAD-7 and PHQ-9,nutrition-related indicators(albumin,prealbumin)which were assessed on the day of patients first visit,1 day before surgery,7 days after surgery were compared between the two groups.At the same time,postoperative complications of cases and postoperative hospitalization days were included.Results The observation group's 6MWDs were measured 1 day before operation and 7 days after operation were better than those of the control group,with statistical significance(P<0.05).GAD-7 and PHQ-9 scores of the observation group were lower than those of the control group 1 day before operation,with statistical significance(P<0.05).7 days after operation,the albumin and prealbumin of the observation group were higher than those of the control group,with statistical significance(P<0.05).The postoperative hospitalization days of the observation group[(16.00±5.66)d]was lower than that of the control group[(20.03±5.52)d],with statistical significance(P<0.05).Conclusion The pre-hospital rehabilitation strategy based on multidisciplinary collaboration is beneficial to enhance the perioperative endurance of esophageal cancer patients.It can reduce their psychological burden,improve their nutritional status,and promote postoperative recovery of them.