预康复理念在肾癌患者腹腔镜根治术后康复中的应用效果

Application effect of prehabilitation concept in the postoperative recovery of patients undergoing laparoscopic radical nephrectomy for renal cancer

目的探讨基于预康复理念的综合管理对肾癌患者腹腔镜根治术后康复的影响,为改善患者预后提供依据。方法采用随机数字表法将98例择期肾癌腹腔镜根治术患者分为预康复组和对照组各49例,比较2组患者的术后疼痛程度、康复情况、焦虑抑郁水平、生活质量和术后并发症发生情况。结果预康复组术后的下床活动时间、进食时间、白细胞恢复正常时间、导尿管拔除时间,以及住院时长均短于对照组,差异均有统计学意义(P<0.05)。术后1 d、3 d、5 d,2组术后VAS量表评分和补液量均随着时间推移而降低,且预康复组各时间点的VAS量表评分均低于对照组,差异均有统计学意义(P<0.05)。出院前,2组患者的焦虑自评量表、抑郁自评量表和成人癌症生存者生命质量量表得分均较干预前降低,且预康复组均低于对照组,差异有统计学意义(P<0.05)。预康复组的并发症发生率(6.12%)低于对照组(16.33%),但2组差异无统计学意义(χ^(2)=2.560,P=0.110)。结论预康复理念下的综合管理可以缓解肾癌患者腹腔镜根治术后的疼痛程度和不良情绪,提升生活质量。

Objective To investigate the impact of comprehensive management based on the prehabilitation concept on the postoperative recovery of patients who have undergone laparoscopic radical nephrectomy for renal cancer,providing evidence for improving patient outcomes.Methods Using the random number table method,98 patients scheduled for laparoscopic radical nephrectomy for renal cancer were randomly divided into a prehabilitation group and a control group,each consisting of 49 cases.The postoperative pain levels,recovery status,levels of anxiety and depression,quality of life,and incidence of postoperative complications were compared between the two groups.Results The prehabilitation group had significantly shorter times to ambulation,initiation of oral intake,normalization of white blood cell count,and removal of urinary catheters,as well as a shorter hospital stay compared to the control group(P<0.05).On postoperative days 1,3,and 5,both groups showed a decrease in VAS pain scores and fluid replacement volume over time,with the prehabilitation group consistently scoring lower than the control group at all time points(P<0.05).Before discharge,thescores of self-rating anxiety scale(SAS),self-rating depression scale(SDS)and quality of life in adult cancer survivors(QLACS)for both groups were reduced compared to pre-intervention,with the prehabilitation group scoring lower than the control group(P<0.05).The incidence of complications in the prehabilitation group(6.12%)was lower than that in the control group(16.33%),but the difference between the two groups was not statistically significant(χ^(2)=2.560,P=0.110).Conclusions Comprehensive management based on the prehabilitation concept can alleviate postoperative pain and negative emotions of renal cancer patients after laparoscopic radical nephrectomy,thereby improving their quality of life.