腹腔镜结直肠癌手术后延长监督康复的每日时长可改善日常生活活动能力。
Longer Daily Duration of Supervised Rehabilitation after Laparoscopic Surgery for Colorectal Cancer Improves Activities of Daily Living.
机构信息
Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences; Clinical Research Center National Hospital Organization.
Clinical Research Center National Hospital Organization; Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan.
出版信息
J Rehabil Med. 2022 Jul 25;54:jrm00304. doi: 10.2340/jrm.v54.1510.
OBJECTIVE
To evaluate the effect of a supervised rehabilitation programme with longer hours per day on activities of daily living after laparoscopic surgery for colorectal cancer.
DESIGN
This study represents retrospective observational use of nationwide administrative data.
PATIENTS
Eligible patients (n = 8,633) were first diagnosed with colorectal cancer between 1 April 2017 and 31 March 2018, underwent laparoscopicassisted colorectal resection, and began rehabilitation within 3 days of surgery.
METHODS
Patients underwent a long (40 min or more) or short (less than 40 min) supervised rehabilitation programme, defined as rehabilitation under physiotherapist and occupational therapist supervision. The main outcome measure was improvement in activities of daily living from postoperative day 0 to day 14 using Nursing Need Degree.
RESULTS
Patients who underwent longer daily supervised rehabilitation (n = 7,173) showed greater improvements in activities of daily living at 14 days after laparoscopic surgery than patients who underwent shorter daily supervised rehabilitation (n = 1,460) (odds ratio (95% confidence interval; 95% confidence interval): 1.42 (1.22-1.64), p < 0.001). The rate of postoperative complications did not differ between groups.
CONCLUSION
Longer daily supervised rehabilitation for colorectal cancer improves activities of daily living after laparoscopic surgery.
目的
评估每天接受更长时间监督康复治疗对腹腔镜结直肠癌手术后日常生活活动的影响。
设计
本研究代表对全国性行政数据的回顾性观察使用。
患者
符合条件的患者（n=8633）于 2017 年 4 月 1 日至 2018 年 3 月 31 日期间首次被诊断患有结直肠癌，接受腹腔镜辅助结直肠切除术，并在手术后 3 天内开始康复治疗。
方法
患者接受长（40 分钟或更长时间）或短（少于 40 分钟）监督康复治疗，定义为在物理治疗师和职业治疗师监督下进行的康复治疗。主要结局指标是使用护理需求程度评估术后第 0 天至第 14 天日常生活活动的改善情况。
结果
与接受较短日常监督康复治疗的患者（n=1460）相比，接受较长日常监督康复治疗的患者（n=7173）在腹腔镜手术后 14 天日常生活活动的改善程度更大（比值比（95%置信区间；95%置信区间）：1.42（1.22-1.64），p<0.001）。两组患者的术后并发症发生率无差异。
结论
对结直肠癌患者进行更长时间的日常监督康复治疗可改善腹腔镜手术后的日常生活活动能力。
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