宫颈癌微创根治术患者术后超早期活动的安全性研究

王卉; 吴治敏; 刘华英; 陈彦丽; 吴娇娇; 王延洲; 邓黎

doi:10.16016/j.2097-0927.202107184

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宫颈癌微创根治术患者术后超早期活动的安全性研究

临床医学 | 更新时间：2026-01-09

- 宫颈癌微创根治术患者术后超早期活动的安全性研究
- Safety of ultra-early postoperative activity after laparoscopic radical hysterectomy for cervical cancer
- 陆军军医大学学报 2022年44卷第3期页码：259-265
- 作者机构：
  
  400038 重庆，陆军军医大学(第三军医大学)第一附属医院妇产科
- 作者简介：
  
  [吴治敏，E-mail: wzm_xnyy@126.comWU Zhimin, E-mail: wzm_xnyy@126.com
- 基金信息：
  
  重庆市科卫联合医学科研项目(2020FYYX059)
- DOI：10.16016/j.2097-0927.202107184
  中图分类号： R473.71;R730.56;R737.33
- 收稿：2021-07-30，
  
  修回：2021-11-11，
  
  纸质出版：2022-02-15
- 稿件说明：
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王卉, 吴治敏, 刘华英, 等. 宫颈癌微创根治术患者术后超早期活动的安全性研究[J]. 陆军军医大学学报, 2022,44(3):259-265.

Hui WANG, Zhimin WU, Huaying LIU, et al. Safety of ultra-early postoperative activity after laparoscopic radical hysterectomy for cervical cancer[J]. Journal of Army Medical University, 2022, 44(3): 259-265.
王卉, 吴治敏, 刘华英, 等. 宫颈癌微创根治术患者术后超早期活动的安全性研究[J]. 陆军军医大学学报, 2022,44(3):259-265. DOI： 10.16016/j.2097-0927.202107184.

Hui WANG, Zhimin WU, Huaying LIU, et al. Safety of ultra-early postoperative activity after laparoscopic radical hysterectomy for cervical cancer[J]. Journal of Army Medical University, 2022, 44(3): 259-265. DOI： 10.16016/j.2097-0927.202107184.

摘要

目的

探讨宫颈癌微创根治术患者术后超早期(0~6 h)活动方案的安全性。

方法

选取本科宫颈癌微创根治术患者118例，采用非随机同期对照研究，根据患者意愿分为术后超早期(0~6 h)活动组58例和常规活动组60例，均采用妇科快速康复围手术期方案进行。术后，常规活动组采用传统的护理方案；超早期(0~6 h)活动组根据宫颈癌微创根治术患者特点采用术后超早期(0~6 h)活动方案，由专职健康教育护士，一对一指导及协助患者并评估完成情况。若患者出现自觉体力不支、心慌、头晕、面色苍白或出冷汗，血氧饱和度＜94%，心率达到Karvonen法的活动靶心率等情况中任意一项，则立即停止该活动方案。

结果

超早期(0~6 h)活动组患者首次下床时间及活动量评分优于常规活动组(

=0.011)；两组患者活动前后血氧饱和度(SpO

)、脉搏、疼痛评分、并发症发生情况差异无统计学意义。住院期间术后3 d平均活动水平优于常规活动组(

=0.000)；患者术后首次排气时间(

=0.020)、最早进食时间(

=0.010)、术后住院天数(

=0.010)均优于常规活动组。

结论

超早期(0~6 h)活动组患者术后24 h全部能下床活动且术后3 d活动量高于常规活动组，术后超早期(0~6 h)活动方案能有效提高宫颈癌术后早期下床活动率，不增加术后并发症的发生。

Abstract

Objective

To investigate the safety of the ultra-early (0~6 h) activity program for patients after minimally invasive radical treatment of cervical cancer.

Methods

A non-randomized concurrent controlled trial was conducted on 118 patients undergoing minimally invasive radical surgery for cervical cancer in our department from June to December 2019. According to patient's wish

they were divided into the ultra-early (0~6 h) postoperative activity group (

=58) and the conventional activity group (

=60). The patients in both groups received the perioperative program of rapid gynecological rehabilitation. After the operation

the conventional activity group adopted the conventional nursing plan

and the ultra-early activity group adopted the ultra-early postoperative activity plan according to the characteristics of patients with one-to-one guidance and assistance by professional health education nurses. If a patient suffered from conscious weakness

palpitation

dizziness

pale or cold sweats

oxygen saturation

94%

or heart rate reaching the target heart rate of Karvonen formula

the activity program would be stopped immediately when any of them presented.

Results

The time to get out of bed for the first time and the activity scores were better in the ultra-early activity group than the conventional activity group (

=0.011). There were no statistically significant differences in SpO

pulse

pain scores

and incidence of complications between the 2 groups before and after activities. The ultra-early activity group had obviously better average activity in 3 d post-operatively during hospitalization (

=0.000)

shorter times to first postoperative exhaust (

=0.020) and to first oral feeding (

=0.010)

and shorter le

ngth of hospital stay (

=0.010) when compared with the conventional activity group.

Conclusion

All patients in the ultra-early activity group are able to get out of bed within 24 h post-operatively

and attain better activity level in 3 d after operation than those of the conventional activity group. Ultra-early postoperative activity program can effectively improve the early out-of-bed activity rate after cervical cancer surgery and have no effect on the occurrence of postoperative complications.

关键词

Keywords

references

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