肺癌患者单孔电视胸腔镜手术术后早期下床活动的现状及影响因素分析

Analysis on the current situation and influencing factors of early ambulation motion after single-port video-assisted thoracoscopic surgery in patients with lung cancer

目的了解肺癌患者单孔电视胸腔镜手术(VATS)术后早期下床活动的现状并探讨其影响因素.方法采用便利抽样法选取2022年10-12月中国医学科学院北京协和医学院肿瘤医院行单孔VATS手术治疗的130例肺癌患者为调查对象,对其早期下床活动的情况进行调查,了解术后早期下床活动现状.对调查结果进行单因素分析和多因素logistic回归分析,分析其影响因素.结果130例患者中101例可完成早期下床活动,完成率77.7%.多因素logistic回归分析显示,以未完成组为参照,患者术后在18:00之后返回病房是完成早期下床活动的独立保护因素,术后24h内出现恶心呕吐、头晕、静息疼痛视觉模拟评分法≥4分是完成早期下床活动的独立危险因素(均P<0.05).结论肺癌患者单孔VATS术后早期下床活动完成率处于中等偏上水平,医护人员可制定相应的护理对策,加强术后恶心呕吐及疼痛症状的管理,合理安排护理人员配比,优化工作流程,以促进患者术后早期康复.

Objective To analyze the current situation and influencing factors of early ambulation motion after single-port video-assisted thoracoscopic surgery(VATS)in patients with lung cancer.Methods Using a convenient sampling method,130 patients with lung cancer who underwent single-port VATS in Cancer Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College from October to December 2022 were selected for investigation.The patients'early ambulation motion was investigated to understand the current situation.Univariate analysis and multivariate logistic regression analysis were performed to explore the influencing factors.Results Early ambulation motion was completed in 101 of 130 patients,with a completion rate of 77.7%.Multivariate logistic regression analysis showed that return to the ward after 18:00 is the independent protective factor of early ambulation motion completion,while nausea and vomiting,dizziness,and resting pain of visual analogue scale score≥4 within 24 hours after surgery were independent risk factors of early ambulation motion completion(all P<0.05).Conclusions The completion rate of early ambulation motion after single-port VATS in patients with lung cancer is moderate to high.Medical and nursing staff can develop appropriate nursing countermeasures to enhance the management of postoperative nausea and vomiting,and pain,reasonably allocate nursing staff ratios,and optimize workflow to promote early postoperative recovery of patients.