Department of Obstetrics and Gynecology, Loyola University Medical Center, Maywood, Illinois.
Obstet Gynecol. 2013 Mar;121(3):533-537. doi: 10.1097/AOG.0b013e318280d50a.
To estimate whether specific ambulation goals affect the adequacy or perceived barriers to ambulation in hospitalized surgical patients after major gynecologic surgery.
One hundred forty-six surgical inpatients were randomized to specific ambulation goals or routine care. We assessed the number of pedometer-recorded steps in the 24 hours preceding discharge as well as patient-identified barriers to ambulation. Groups were compared using the Mann-Whitney U test.
Of the 129 participants with outcome data, 12% were discharged without any pedometer-recorded steps. We did not detect an effect of specific ambulation goals by group (routine care: 87 compared with ambulation goals: 80, P=.7). The three main barriers to ambulation from a patient perspective were indwelling catheters (38.5%), intravenous poles (28%), and pain (12.5%) The median number of postoperative steps was higher after minimally invasive surgery (143) compared with laparotomy (27) (P=.035).
Approximately 12% of gynecologic surgical patients do not walk while hospitalized despite formal encouragement to ambulate. Ambulation is easily quantified and may improve with attention to modifiable barriers, potentially improving postoperative recovery.
评估特定的活动目标是否会影响大妇科手术后住院手术患者的活动充分性或对活动的感知障碍。
146 名外科住院患者被随机分配到特定的活动目标或常规护理组。我们评估了出院前 24 小时内计步器记录的步数以及患者识别的活动障碍。使用 Mann-Whitney U 检验比较组间差异。
在 129 名有结局数据的参与者中，有 12%的患者出院时没有记录任何计步器数据。我们没有发现特定活动目标组的效果差异（常规护理组：87 例，活动目标组：80 例，P=.7）。从患者角度来看，活动的三个主要障碍是留置导尿管（38.5%）、静脉杆（28%）和疼痛（12.5%）。微创手术后术后步数中位数较高（143 步），与剖腹手术（27 步）相比（P=.035）。
尽管正式鼓励活动，但约有 12%的妇科手术患者在住院期间不活动。活动很容易量化，通过关注可改变的障碍，可能会改善术后恢复。
