摘要
目的 探讨早期强化康复对输尿管软镜碎石术后下尿路症状及出院准备度的影响。方法 前瞻性选取2024年3月~2025年3月于首都医科大学附属北京朝阳医院行输尿管软镜激光碎石取石术治疗的150例肾结石患者进行研究,并依据随机数表法分为强化康复组(75例)和常规组(75例)。两组患者在围术期均采用加速康复外科模式(ERAS)进行干预,强化康复组则在此基础上采用早期强化康复进行干预。比较两组患者干预前后的疼痛视觉模拟评分(VAS)、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分、下尿路症状发生情况、出院准备度量表(RHDS)各维度(适应能力、个人状态、预期性支持)评分、出院指导质量量表(QDTS)各维度(需要的内容、指导技巧及效果、获得的内容)评分。结果 干预后,强化康复组VAS评分、SAS评分、SDS评分均低于常规组,差异有统计学意义(t=12.830、8.873、6.779,P<0.05);强化康复组术后7和14 d的下尿路症状发生率均低于常规组,差异有统计学意义(χ^(2)=5.720、4.807,P<0.05);干预后强化康复组RHDS各维度评分及总分与QDTS各维度评分及总分均高于常规组(t=5.221、5.365、6.931、6.667、5.590、6.749、5.934、10.221,P<0.05)。结论 基于ERAS下行输尿管软镜激光碎石取石术后患者采用早期强化康复干预能够显著降低其疼痛程度、焦虑抑郁负性情绪以及术后下尿路症状发生率,提升出院准备度和出院指导质量。
Objective To investigate the effect of early intensive rehabilitation on lower urinary tract symptoms and discharge readiness after flexible ureteroscopic lithotripsy.Methods A total of 150 patients with renal calculi who underwent flexible ureteroscopic laser lithotripsy in our hospital from March 2024 to March 2025 were prospectively selected and divided into intensive rehabilitation group(75 cases)and routine group(75 cases)according to the random number table method.Both groups of patients were treated with enhanced recovery after surgery(ERAS)during the perioperative period,and the intensive rehabilitation group was treated with early intensive rehabilitation on this basis.The pain visual analogue scale(VAS),self-rating anxiety scale(SAS)score,self-rating depression scale(SDS)score,lower urinary tract symptoms,readiness for hospital discharge scale(RHDS)each dimension(adaptability,personal status,expected support)score,discharge guidance quality scale(QDTS)each dimension(required content,guidance skills and effects,obtained content)score were compared between the two groups.Results After intervention,the VAS score,SAS score and SDS score of the intensive rehabilitation group were lower than those of the conventional group(t=12.830,8.873,6.779,P<0.05);the incidence of lower urinary tract symptoms in the intensive rehabilitation group was lower than that in the conventional group at 7 and 14 days after operation.(χ^(2)=5.720,4.807,P<0.05).After intervention,the scores and total scores of RHDS and QDTS in the intensive rehabilitation group were higher than those in the conventional group(t=5.221,5.365,6.931,6.667,5.590,6.749,5.934,10.221,P<0.05).Conclusion Early intensive rehabilitation intervention for patients undergoing flexible ureteroscopic laser lithotripsy based on ERAS can significantly alleviate the degree of pain,negative emotions of anxiety and depression,and the incidence of postoperative infection,and improve the readiness for discharge and the quality of discharge guidance.
作者
崔丽艳
杨宇
蒋一航
靳清
CUI Liyan;YANG Yu;JIANG Yihang;JIN Qing(Department of Urology,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)
出处
《中华保健医学杂志》
2026年第1期78-81,共4页
Chinese Journal of Health Care and Medicine
基金
北京市属医院科研培育计划项目(px2024013)。
关键词
早期强化康复
输尿管软镜激光碎石取石术
加速康复外科模式
下尿路症状
出院准备度
early intensive rehabilitation
flexible ureteroscopy laser lithotripsy
accelerated rehabilitation surgery mode
lower urinary tract symptoms
discharge readiness
作者简介
通信作者:靳清,E-mail:jinqing1966@163.com。
