术前多维度预康复对胃肠道术后患者恢复及心理状态的影响 [中文引用][英文引用]

目的 探讨基于快速康复外科理念（enhanced recovery after surgery，ERAS）的术前多维度预康复对胃肠道手术患者术后恢复及心理状态的影响。方法 将 2022 年 1 月至 2023 年 6 月本院收治的 55 例胃肠道手术患者设为对照组，给予常规干预；将 2023 年 7 月至 2024 年 1 月本院收治的 55 例胃肠道手术患者设为试验组，给予基于 ERAS 理念的术前多维度预康复干预。比较两组术后胃肠功能恢复情况、心理状态、认知功能及并发症发生率。结果 试验组患者术后肠鸣音恢复、肛门排气、首次排便、下床活动及胃管拔除时间均早于对照组；术后 3d，试验组患者总蛋白、前白蛋白、白蛋白术后 3d- 入院当天变化差值高于对照组；术后 3d，试验组患者健康问卷抑郁量表（patient health questionnaire-9，PHQ-9）评分低于对照组，简易智能精神状态量表（mini-mental state examination，MMSE）评分术后 3d- 入院当天变化差值高于对照组；试验组患者术后并发症发生率低于对照组，差异具有统计学意义（均 P<0.05）。结论 基于 ERAS 理念的术前多维度预康复能促进胃肠道手术患者术后胃肠功能快速恢复，改善心理状态及认知功能，减少并发症发生。

Objective To investigate the effects of preoperative multidimensional pre-rehabilitation based on the concept of accelerated rehabilitation surgery（ERAS）on postoperative gastrointestinal function and psychological status in patients who received gastrointestinal surgery. Methods A total of 110 patients who underwent gastrointestinal surgery in our hospital from January 2022 to January 2024 were enrolled in this study. Patients who underwent gastrointestinal surgery from January 2022 to June 2023（n=55）were assigned into control group and offered with routine intervention, while patients from July 2023 to January 2024（n=55）were assigned into trial group and offered with postoperative multidimensional rehabilitation interventions based on ERAS. The two groups were compared in terms of recovery of gastrointestinal function, psychological state, cognitive function and the incidence of postoperative complication. Results The trial group demonstrated earlier recovery of bowel sound, flatus passage, first defecation, off-bed ambulation and nasogastric extubation than that of the control group. The trial group had significantly higher difference values of total protein, prealbumin and albumin of blood test between day-3 after surgery and the day of admission（all P<0.001）. The trial group exhibited significantly difference values of scores on the patient health questionnaire-9（PHQ-9）and higher scores on the mini-mental state examination（MMSE） between day-3 after surgery and the day of admission than those in the control group（all P<0.001）. The trial group was significantly lower than that of the control group（P<0.001）. Conclusion Multi-dimensional pre-rehabilitation based on the ERAS can promote a rapid recovery of gastrointestinal function, improve mental status and cognitive function, and reduce complications in the patients with gastrointestinal surgery.