目的: 探究基于最佳循证证据总结的三联预康复在老年胆石症患者衰弱改善中的应用价值。方法: 选取2024年7月—2024年10月在我院拟行择期手术老年胆石症患者56例,依据干预方法不同随机分为实验组和对照组,每组28例。对照组采用常规术前准备,实验组则实施基于最佳循证证据总结的三联预康复干预。比较两组患者干预前后的6分钟步行距离（6-minute walk distance,6MWD）、白蛋白（albumin,ALB）、医院焦虑抑郁量表（hospital anxiety and depression scale,HADS）评分、FRAIL衰弱量表评分和首次下床活动时间、住院时间、患者满意率。结果: 实施干预后,实验组术前24 h、术后5 d的6MWD、ALB和HADS评分均明显优于照组;实验组术前24 h、术后5 d、术后30 d的FRAIL衰弱量表评分均低于对照组;实验组首次下床活动时间、住院时间短于对照组;实验组患者满意率虽高于对照组,但差异无统计学意义。结论: 老年胆石症患者在术前实施基于最佳循证证据总结的三联预康复,有助于改善老年胆石症患者衰弱状态,提高患者住院满意度,促进患者术后快速康复。
Abstract
Objective To explore the application value of triple prehabilitation based on the best evidence summary in improving frailty in elderly patients with cholelithiasis. Method A total of 56 elderly patients with cholelithiasis scheduled for elective surgery in our hospital from July 2024 to October 2024 were selected and randomly divided into an experimental group and a control group, with 28 cases in each group, based on different intervention methods. The control group received conventional preoperative preparation, while the experimental group was subjected to a three-pronged prehabilitation intervention based on the summary of the best evidence-based practice. The 6-minute walk distance (6MWD), albumin (Alb), Hospital Anxiety and Depression Scale (HADS) score, FRAIL frailty scale score, time to first ambulation, hospital stay, and patient satisfaction rate were compared between the two groups before and after the intervention. Results After the intervention, the 6MWD, Alb, and HADS scores of the experimental group at 24 hours before surgery and 5 days after surgery were significantly better than those of the control group; the FRAIL frailty scale scores of the experimental group at 24 hours before surgery, 5 days after surgery, and 30 days after surgery were lower than those of the control group; the time to first ambulation and hospital stay of the experimental group were shorter than those of the control group, and the patient satisfaction rate of the experimental group was higher than that of the control group. Conclusion Preoperative implementation of a three-pronged prehabilitation based on the summary of the best evidence-based practice for elderly patients with cholelithiasis can help improve their frailty status, increase their satisfaction with hospitalization, and promote their rapid postoperative recovery.
关键词
老年患者 /
胆石症 /
衰弱 /
三联预康复
Key words
elderly patients /
cholelithiasis /
frailty /
triple pre-rehabilitation /
summary of evidence
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基金
湖南省科技创新计划项目“肝胆外科老年衰弱患者三联预康复干预策略的构建及应用研究”（2021SK50909）;湖南省卫生健康高层次人才重大科研专项“公众急救科普‘湖南模式’实践及效果的循证评价”（R2023072）;湖南省财政厅科研项目“老年心血管疾病患者院前急救预警响应模式的构建研究”（湘财教指〔2022〕75号）;湖南省财政厅科研项目“基于一键呼救的心脑血管病整体联动智慧急救模式构建研究”（湘财教指〔2021〕59号）
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