将准备好的患者家属纳入麻醉与重症监护室肿瘤外科患者的早期康复过程

A. Saetgaraev, I. Maximov, I. Zakirov, I. V. Shaymardanov, I. Grigoreva, M. E. Guryleva
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Patients, similar in age and condition (American Society of Anaesthesiologists Physical Status category IIIE) were divided into three equal groups: the first group generally accepted measures for early rehabilitation were carried out by medical staff; the second group the prepared relatives of the patient was additionally involved in rehabilitation; the control group early rehabilitation was not carried out. The quality of nutritional support and measures to prevent pressure ulcers, cognitive function were assessed. Statistical processing was performed by using Microsoft Excel 2007 and IBM SPSS Statistics version 20 software. The statistical significance of data was determined by using the chi-square test at p 0.05. \nResults. The involvement of previously trained relatives made it possible to reduce the incidence of pressure ulcers grade IV to 0%. 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摘要

的目标。探讨老年外科肿瘤患者的培训环境对重症监护病房(ICU)术后早期康复综合干预质量的影响。方法。2016年至2020年期间,96例年龄73.37.1岁的患者在鞑靼斯坦共和国卫生部鞑靼斯坦癌症中心的急诊外科诊所接受了手术。年龄和病情相近的患者(美国麻醉医师学会物理状态分类IIIE)分为三组:第一组由医务人员实施普遍接受的早期康复措施;第二组患者的家属也参与了康复治疗;对照组不进行早期康复治疗。评估营养支持的质量和预防压疮、认知功能的措施。采用Microsoft Excel 2007和IBM SPSS Statistics version 20软件进行统计处理。采用χ 2检验,p < 0.05。结果。以前受过训练的亲属的参与使IV级压疮的发生率降低到0%成为可能。同化肠内口服喂养量差异有统计学意义(180.620.8;240.620.8;80.510.2;术后11 d血清白蛋白水平(26.81.5;28.91.2;分别为24.21.1 g/L;p 0.05)。肠内口服喂养的同化率比对照组提高3倍,比第1组提高1.5倍(p < 0.05)。第6天Mini Mental State Examination (MMSE)认知状态指标为23.31.1;25.31.1;21.21.2 (p 0.05)。结论。合理组织准备患者实施护理、参与康复措施和预防并发症的环境,可以提高医疗干预的效果,减少术后并发症的发生。
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Inclusion of the prepared patient relatives in the process of early rehabilitation of onco-surgical patients in the department of anesthesiology and intensive care
Aim. To study the influence of the trained environment of geriatric onco-surgical patients on the quality of the interventions in the complex of early postoperative rehabilitation in the Intensive Care Unit (ICU). Methods. The 96 patients aged 73.37.1 years operated on in the emergency onco-surgery clinic of the Tatarstan Cancer Center of the Ministry of Health of the Republic of Tatarstan between 2016 and 2020. Patients, similar in age and condition (American Society of Anaesthesiologists Physical Status category IIIE) were divided into three equal groups: the first group generally accepted measures for early rehabilitation were carried out by medical staff; the second group the prepared relatives of the patient was additionally involved in rehabilitation; the control group early rehabilitation was not carried out. The quality of nutritional support and measures to prevent pressure ulcers, cognitive function were assessed. Statistical processing was performed by using Microsoft Excel 2007 and IBM SPSS Statistics version 20 software. The statistical significance of data was determined by using the chi-square test at p 0.05. Results. The involvement of previously trained relatives made it possible to reduce the incidence of pressure ulcers grade IV to 0%. There was a significant difference in the volume of assimilated enteral oral feeding (180.620.8; 240.620.8; 80.510.2; p 0.05) and the serum albumin level by 11 days after surgery (26.81.5; 28.91.2; 24.21.1 g/L, respectively; p 0.05). Assimilation of enteral oral feeding improved 3 times compared with the control group and 1.5 times compared with the first group (p 0.05). Indicators of cognitive status by the Mini Mental State Examination (MMSE) on the 6th day were 23.31.1; 25.31.1; 21.21.2 (p 0.05), respectively. Conclusion. A rationally organized preparation of the patient's environment for the implementation of care, participation in rehabilitation measures and the prevention of complications can improve outcomes of medical intervention and reduce the incidence of postoperative complications.
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