妇科生殖手术患者加速康复手术围术期体能状况及运动软件测量可行性研究

A study on the physical fitness status of gynecological patients with enhanced recovery after surgery during perioperative period and the feasibility of measuring physical fitness using the Keep fitness App

目的调查妇科良性疾病患者加速康复手术(ERAS)围术期的6 min步行试验(6MWT)现状以反映患者围术期的体能状况变化,同时探讨Keep运动软件测量6 min步行距离(6MWD)的可行性。方法选取2023年2月至2024年1月在北京协和医院妇科病房的150例妇科生殖手术患者,采用临床病例报告表收集患者的一般资料及临床资料,在术前、术后第1天和出院当天分别进行6MWT,研究者采用指南标准测试法和Keep软件测距法同时记录6MWD及相关指标,分析两种测试方法的差异及相关性。结果妇科患者ERAS术前6MWD实测距离为(513.85±68.46)m,Keep距离为490(470,560)m;术后第1天6MWD实测距离为(295.91±99.04)m,Keep距离为410(340,450)m;出院当天6MWD实测距离为(376.78±103.40)m,Keep距离为(448.14±94.09)m。6MWD实测值和Keep值均呈现下降后上升的趋势。术前、术后第1天、出院当天的6MWD实测值和Keep值均存在正相关(相关系数r分别为0.377、0.762、0.701)。术前6MWD实测值与Keep值比较无显著差异(P=0.946),术后第1天及出院当天的实测值与Keep值比较有显著差异(P<0.001)。结论妇科生殖手术患者围术期的6分钟步行能力处于较强水平,术后体能状况恢复较为满意,使用Keep软件测量6 min步行距离存在不准确的情况。

Objective:To investigate the status of 6-minute walk test(6MWT)of gynaecological enhanced recovery after surgery(ERAS)during perioperative period in order to reflect the changes of physical function in patients and to explore the feasibility of Keep software for measurement of 6-minute walk distance(6MWD).Methods:A total of 150 patients with benign gynaecological diseases were selected in Peking Union Medical College Hospital from February 2023 to January 2024.General and clinical information of patients were collected with clinical case report form.6MWT was performed before surgery,on the first day after surgery,and on the day of discharge.6MWD and its related indicators were recorded simultaneously by the investigator using Guidelines for standard testing methods and Keep software.The differences and correlations between two testing methods were evaluated.Results:The measured 6MWD in patients with benign gynaecological diseases before ERAS was(513.85±68.46)m and Keep distance was 490(470,560)m.6MWD on the first postoperative day was(295.91±99.04)m and the Keep distance was 410(340,450)m.On the day of discharge,the measured 6MWD was(376.78±103.40)m,and the Keep distance was(448.14±94.09)m.The measured 6MWD and Keep values showed a decreasing and then increasing trend.There was a positive correlation between the measured 6MWD and Keep values preoperatively,on the first postoperative day,and on the day of discharge(r=0.377,r=0.762,r=0.701).There was no statistically significant difference between the measured and Keep values of the preoperative 6MWT(P=0.946),and there were statistically significant differences between the measured 6MWD and the Keep values on the first postoperative day and on the day of discharge(P<0.001).Conclusions:The 6-minute walking ability of patients with gynecological reproductive surgery was at a strong level in the perioperative period.The recovery of postoperative physical condition was satisfactory.There were inaccuracies in the measurement of 6MWD using Keep.