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拟行择期结直肠手术患者新的运动康复方案的可行性:一项可行性随机对照试验。

Feasibility of a novel exercise prehabilitation programme in patients scheduled for elective colorectal surgery: a feasibility randomised controlled trial.

机构信息

Hull Health Trials Unit, University of Hull, Hull, UK.

Sport, Health and Exercise Science, School of Life Sciences, University of Hull, Hull, UK.

出版信息

Support Care Cancer. 2020 Jul;28(7):3197-3206. doi: 10.1007/s00520-019-05098-0. Epub 2019 Nov 12.

Abstract

BACKGROUND AND OBJECTIVES

To investigate the feasibility of delivering a functional exercise-based prehabilitation intervention and its effects on postoperative length of hospital stay, preoperative physical functioning and health-related quality of life in elective colorectal surgery.

MATERIALS AND METHODS

In this randomised controlled feasibility trial, 22 elective colorectal surgery patients were randomly assigned to exercise prehabilitation (n = 11) or standard care (n = 11). Feasibility of delivering the intervention was assessed based on recruitment and compliance to the intervention. Impact on postoperative length of hospital stay and complications, preoperative physical functioning (timed up and go test, five times sit to stand, stair climb test, handgrip dynamometry and 6-min walk test) and health-related quality of life were also assessed.

RESULTS

Over 42% of patients (84/198) screened were deemed ineligible for prehabilitation due to insufficient time existing prior to scheduled surgery. Of those who were eligible, approximately 18% consented to the trial. Median length of hospital stay was 8 [range 6-27] and 10 [range 5-12] days respectively for the standard care and prehabilitation groups. Patterns towards preoperative improvements for the timed up and go test, stair climb test and 6-min walk test were observed for all participants receiving prehabilitation but not standard care.

CONCLUSIONS

Despite prehabilitation appearing to convey positive benefits on physical functioning, short surgical wait times and patient engagement represent major obstacles to implementing exercise prehabilitation programmes in colorectal cancer patients.

摘要

背景与目的

研究在择期结直肠手术中实施基于功能锻炼的预康复干预的可行性,及其对术后住院时间、术前身体机能和健康相关生活质量的影响。

材料与方法

在这项随机对照可行性试验中,22 例择期结直肠手术患者被随机分配至锻炼预康复组(n=11)或标准照护组(n=11)。基于干预措施的招募和依从性评估其可行性。还评估了对术后住院时间和并发症、术前身体机能(计时起立行走测试、五次坐站测试、爬楼梯测试、握力测试和 6 分钟步行测试)和健康相关生活质量的影响。

结果

在筛选出的 198 例患者中,有 42%(84/198)因术前可用于预康复的时间不足而被认为不适合预康复。在符合条件的患者中,约有 18%同意参加试验。标准照护组和预康复组的中位住院时间分别为 8[范围 6-27]天和 10[范围 5-12]天。所有接受预康复的患者都表现出术前计时起立行走测试、爬楼梯测试和 6 分钟步行测试的改善趋势,但标准照护组则没有。

结论

尽管预康复似乎对身体机能有积极影响,但较短的手术等待时间和患者参与度是在结直肠癌患者中实施锻炼预康复计划的主要障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e672/7256075/f840f465d41d/520_2019_5098_Fig1_HTML.jpg

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