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基于 RoSCo 评分系统的早期下床活动时机在肾肿瘤患者术后的应用

Application of early mobilization timing based on RoSCo scoring system in postoperative renal tumor patients

:1656-1662
 
       目的   探讨基于手术风险模型(RoSCo)评分系统的早期下床活动时机在肾肿瘤患者术后的应用效果。方法   选取2021年6月—2024年6月天津市人民医院收治的80例肾肿瘤患者,应用随机数字表法将其分为观察组与对照组,各40例。80例患者均实施腹腔镜肾部分切除术,对照组实施常规干预与术后早期下床活动干预,观察组实施常规干预与基于RoSCo评分系统的早期下床活动时机干预。对比两组术后康复水平,疼痛程度与睡眠质量,并发症发生率及生活质量。结果   观察组首次下床活动(19.30±4.17)h、排气(22.03±4.15)h、排便时间(29.93±5.58)h及术后住院时间(5.35±1.33)h短于对照组[(25.08±5.11)、(29.38±5.75)(34.20±5.98)(7.35±2.38)]h,对比差异有统计学意义(t=-5.540、-6.557、-3.308、-4.637,P<0.05);手术后,观察组视觉模拟量表(VAS)评分(3.93±0.92)分、PSQI评分(9.13±1.64)分高于对照组[(5.38±1.25)、(12.23±2.40)]分,对比差异有统计学意义(t=-5.902、-6.747,P<0.05);观察组并发症发生率7.50%低于对照组27.50%(χ 2 =5.541,P=0.019);手术后观察组SF-36评分相关维度[生理职能(84.45±9.74)、总体健康(60.75±10.65)、躯体疼痛(65.65±8.60)、生理功能(72.98±9.22)、活力(71.95±6.93)、社会功能(75.38±8.33)、精神健康(75.63±8.02)、情感职能(65.43±9.70)]分值高于对照组[生理职能(69.98±10.09)、总体健康(53.58±7.96)、躯体疼痛(58.83±9.35)、生理功能(65.68±7.58)、活力(62.83±12.80)、社会功能(68.98±10.99)、精神健康(71.58±9.69)、情感职能(57.90±6.86)]分值,对比差异有统计学意义(t=6.530、3.414、3.398、3.870、3.966、2.936、2.037、4.004,P<0.05)。结论   针对肾肿瘤患者术后应用基于RoSCo评分系统的早期下床活动时机干预可促进其术后康复,辅助减轻术后疼痛程度,提升睡眠质量,降低并发症发生率,进一步提升患者生活质量。
      Objective  To explore the application effect of early mobilization timing  based on the Risk of  Surgical Complication(RoSCo)scoring system in renal tumor patients after surgery.Methods  From June 2021 to June 2024,80 patients with renal tumors admitted to the hospital were selected as the research subjects.They were  randomly divided into an observation group and a control group using a random number table method,with 40 patients in each group.All patients underwent laparoscopic partial nephrectomy.The control group received routine care and early postoperative mobilization intervention,while the observation group received routine care and early mobilization intervention based on the RoSCo scoring system.The postoperative rehabilitation level,pain level and sleep quality,incidence of complications,and quality of life between two groups were compared.Results  The first time getting out of bed,exhaust,defecation and postoperative hospitalization time in observation group([19.30±4.17]h,[22.03±4.15]h,[29.93±5.58]h,[5.35±1.33]h) were shorter than those in control group([25.08±5.11]h,[29.38±5.75]h,[34.20±5.98]h,[7.35±2.38]h),the  differences  were  statistically significant(t=-5.540,-6.557,-3.308,-4.637,all P<0.05).After operation,VAS score(3.93±0.92)and PSQI score(9.13±1.64)in the observation group were higher than those in the control group([5.38±1.25]and[12.23±2.40]),and the differences were statistically significant(t=-5.902,-6.747,both P<0.05).The complication  rate of the observation group (7.50%) was lower than that of the control group(χ 2 =5.541,P=0.019).After operation,SF-36 scores in the observation group were physiological function(84.45±9.74),general health(60.75±10.65),physical pain(65.65±8.60),physiological function(72.98±9.22),vitality(71.95±6.93),social function(75.38±8.33),spiritual health(75.63±8.02)and emotional function(65.43±9.70),which were higher than those of the control group(physiological function[69.98±10.09],general health[53.58±7.96],physical pain[58.83±9.35],physiological function[65.68±7.58]and vitality[62.83±12.80],social function[68.98±10.99],mental health[71.58±9.69],emotional function[57.90±6.86]),and the differences were statistically significant(t=6.530,3.414,3.398,3.870,3.966,2.936,2.037,4.004,all P<0.05)Conclusions  Early mobilization intervention based on the RoSCo scoring system can promote postoperative recovery,assist in reducing postoperative pain,improve sleep quality,reduce the incidence of complications,and further enhance the quality of life of patients with renal tumors.
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