腹腔镜胆囊切除术后病人早期下床活动现状及影响因素分析

    Analysis of the current situation and influencing factors of early out-of-bed activities in patients after laparoscopic cholecystectomy

    • 摘要: 目的:了解行腹腔镜胆囊切除术(LC)病人术后早期下床活动现状,并分析其影响因素。方法:应用便利抽样法,选择行LC病人139例为研究对象,收集LC病人的一般资料、疾病资料和术后躯体疼痛、疲劳、恶心呕吐及下床活动情况,分析影响病人术后早期下床活动的因素。结果:139例LC病人中,首次下床病人46例,早期下床率为33.09%。2组病人引流管使用及拔除时间、导尿管使用及拔除时间和术后疼痛、疲劳、恶心呕吐及跌倒史、术前体力、直立不耐受、术后早期下床意愿得分差异均有统计学意义(P<0.05~P<0.01);logistic回归分析显示,留置引流管、术后疼痛、术前体力、直立不耐受、术后下床活动意愿均为LC病人术后早期下床活动的独立影响因素(P<0.05~P<0.01)。结论:LC病人术后早期下床活动率有待提高,临床应注意筛查术前体力活动水平较低的病人,术后需关注留置引流管、容易出现直立不耐受的病人,及早干预以增强病人术后下床活动意愿。

       

      Abstract: Objective: To understand the current situation of early out-of-bed activities in patients treated with laparoscopic cholecystectomy(LC),and analyze its influencing factors. Methods: By using the convenience sampling method,139 patients treated with LC were selected as the research subjects.The general information,disease information,postoperative physical pain,fatigue,nausea,vomiting and situation of out-of-bed activities of LC patients were collected,and the factors influencing early out-of-bed activities of patients were analyzed. Results: Among the 139 LC patients,the first time of out-of-bed in 46 cases was found,and the early out-of-bed rate was 33.09%.The differences of the scores of drainage tube usage and removal time,urinary catheter usage and removal time,postoperative pain,fatigue,nausea,vomiting and fall history,preoperative physical strength and upright intolerance,and willingness to get out of bed early after surgery were statistically significant between two groups(P<0.05 to P<0.01).The results of logistic regression analysis showed that the indwelling drainage tube,postoperative pain,preoperative physical strength,upright intolerance and willingness of early out-of-bed activities after surgery were the independent influencing factors of postoperative early out-of-bed activities in LC patients(P<0.05 to P<0.01). Conclusions: The early out-of-bed rate of LC patients after surgery needs to be improved.Clinically,the attention should be paid to screening patients with low preoperative physical activity levels.After surgery,the attention should be paid to patients with indwelling drainage tube and those prone to upright intolerance.Early intervention should be carried out to enhance the patients' willingness of early out-of-bed activities around after surgery.

       

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