| Researching early ambulation’s quantization and effect among Gastric cancer postoperative patients of Enhanced Recovery After SurgeryObjective: 1. Accelerate rehabilitation surgery postoperative patients with gastric cancer of bed activities of quantitative research, realize the patients of postoperative ambulation quantitative guidance. 2. Compare two different quantitative methods and effect of ambulation, explore a suitable quantitative activities accelerate rehabilitation surgery postoperative patients with gastric cancer objective method. 3. Develop path ambulation accelerate rehabilitation surgery postoperative patients with gastric cancer, so as to promote patients recover.Methods: In August 2014- February 2015 selected general hospital of nanjing military region general surgery undergoing elective radical surgery of 66 cases of patients with gastric cancer.According to the order of admission number, in according to random number table is divided into experimental group and the control group(n = 33).In order to avoid the mutual influence between patients, put two groups of patients in the ward nurse stood on either side of the room.Adopt to accelerate rehabilitation surgery concept in both groups, the experimental group on the day of surgery patients return to normal surgical care unit started wearing a wireless smart bracelet(fitbit flex), until the third day, and through the bracelet synchronous real-time computer digital panel, objective observation and monitoring activities, intervention and urge its positive activity; Control group were treated by the traditional way, every time after surgerybed activities, namely wear pedometers monitoring activity, not to interfere in their activities. Compare two groups of patients with postoperative activity steps, distance, activity effect and compliance.Results: The experimental group and control group in patients with postoperative steps 1, 2, 3 d activities, respectively(208.70 + 45.76) vs(144.36 + 47.68) step,(560.73-148.67) vs(407.00 + 85.92) step,(894.70-91.68) vs(674.00 + 73.06) step;Distance(119.52 + 7.81) vs(100.97-9.48) m,(229.45-11.02) vs(201.12 + 14.92) m,(296.36-13.63) vs(264.97 + 25.94) m, had statistical significance(P < 0.01).Bed the first time two groups of patients, respectively(17.03 + 2.97) vs(20.24 + 2.35) h, discharge the BMI respectively(21.15 + 1.13) vs(20.54 + /- 1.21 kg/m2, aeration time, respectively(24.42 + 6.91) vs(35.64 + 15.49) h, defecate time is respectively(34.82 + 13.38) vs(44.21 + 20.71) h, adherence and activity, had statistical significance(P < 0.05).Conclusion: 1. Wireless smart bracelet postoperative ambulation quantitative method is objective and effective, can be continuous, dynamic and real-time monitoring activity, superior to the traditional quantitative method 2. Realized the quantification of postoperative ambulation, improve the effect of the activity, make the patients activities increase in the number of steps, extended range 3. Improve patient compliance; Promote accelerated rehabilitation surgery recovery of postoperative patients with gastric cancerFirst ventilation and influence factors analysis among accelerate rehabilitation surgery gastric cancer postoperative patients of Enhanced Recovery After SurgeryObjective: To understand the accelerate rehabilitation surgery first ventilation in patients with postoperative gastric cancer, and to analyze its influencing factors.Methods: using self-designed general information and operation situation of the registration form, accelerate rehabilitation surgery postoperative ambulation registration form, wireless smart bracelet(fitbit charge) record activity, postoperative intestinal function recovery form of ventilation, etc., preoperative use KPS function scale(applicable to tumor patient) evaluation function, hospital anxiety depression scale(HAD) to evaluate the patient’s emotional state. Retrospective analysis in February 2015- February 2015, 105 cases of accelerated rehabilitation surgery postoperative patients with gastric cancer for the first time ventilation time conditions, its influencing factors were investigated.Results: Of 105 cases of patients with 60 cases within 48 hours for ventilation, ventilation time of postoperative(37.10-10.16) for the first time h, the Da Vinci robot in patients with gastric cancer radical surgery for 45 cases, for the first time, aeration time for postoperative h(27.38 + 7.20);45 patients for 48 hours after the ventilation, ventilation for the first time for postoperative h(57.62 + 7.00);Leonardo Da Vinci robots in 105 patients under a total of 58 patients with gastric cancer radical, aeration time for postoperative(39.79-13.74) h for the first time; Within 48 hours of the first 48 hours after ventilation and ventilation of the patient’s activity level, respectively(484.23 + 137.34) vs(334.00 + 97.87), the difference was statistically significant; In postoperative gastric cancer patients for the first time the influence factors of theventilation time Logistic regression analysis, select the main factors influencing the ventilation for the first time: operation method(B = 0.820, OR = 2.271, P ﹤ 0.05), patients with postoperative activity(B = 0.048, OR = 0.048, P ﹤ 0.01).Conclusion:Enhanced Recovery After Surgery combined with da Vinci robotic minimally invasive surgery can further reduce patient trauma and the stress response and protect the intestinal barrier function, reduced intestinal microflora disorders, accelerating patient ventilation for the first time; increased activity levels in patients with postoperative gastric cancer patients with accelerated first time and promoting recovery of intestinal function, the clinic has some significance. |
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