| Objective:1 Explore the best ambulation time and intensity after colorectal cancer operation, provide scientific proofs for clinical rehabilitation, reduce postoperative complications and facilitate the patient recovery.2 Provide theoretical basis for the future further study of early ambulation.Methods: From 2013 October to 2014 December, in the Department of Gastrointestinal Surgery, the Second Affiliated Hospital of Hebei Medical University, according to the pathological diagnosis, 120 cases of colon cancer patients are chosen as the research objects, and randomly divided into the experiment groups of test group one, test group two, and test group three. Comparison of three groups of patients in age, gender, general education level data shows no significant difference(P > 0.05). When colon cancer patients are sane; the blood pressure, the heart rate, the oxygen saturation are stability, with no anesthetic complications or anesthetic discomfort; there isn’t massive errhysis in the peritoneal incision, and no heavy bleeding at the abdominal drainage tube; and the muscle strength assessment reaches level three or above, patients can get out of bed for ambulation. Group 1 starts ambulation 24 h after the operation, Group 2 starts 48 h after operation and Group 3 72 h after operation. If the health conditions permit, the patient is allowed to sit at the bedside for five minutes, during which feel the patient’s radial artery and count the heart rate to determine whether it is within the normal range(60-100 times/ minute), and ask about how the patient feels. If the patient doesn’t have palpitation, dizziness or other complaints, the nurse can hold the patient under his arms and instruct the patient to put his hands on the shoulders of the nurse to assist the patient in walking, on the condition that no discomfort is shown by the patient and the drainage tubes are properly fixed. The ambulation intensity is 10 meters’ walk for 3 or 4 times daily independently or with assistance.Compare the four recovery indicators of flatus time, gastric drainage during the three days after operation, the incidence of thrombus of lower extremity veins and the incidence of urinary retention. Adopt SPSS19.0 to conduct statistical analysis, carry out normality and homogeneity of variance test to the materials, conduct t test upon the flatus time and gastric drainage during the three days after operation, and conduct x2 test upon the incidence of thrombus of lower extremity veins. Explore the best time and intensity of postoperative ambulation in order to promote recovery and reduce postoperative complications, and provide theoretical guidance for future clinical work.Results: The basic characteristics of the investigation objectsThe age range of the three groups are: Group 1: 52.3 + 6.7, Group 2: 55.4 + 6.3 and Group 3: 53.6 + 7.6. Their operation time are 2.8h + 0.2h, 2.7h + 0.3h, and 2.7h + 0.4h respectively. In terms of the education background, the number of patients with high school and above degree in the three groups are 17, 14 and 15 respectively. There shows no statistical difference(P> 0.05) in the age, operation time and education degree of the patients.Comparison of anal exhaust time of patients in the three groupsThe anal exhaust time of each group is: Group 1 76.0(7.0)h, Group 2 98.0(14.0)h and Group 398.0(14.0)h. This item has statistical difference(H=84.02,P=0.000). Further pairwise comparison also shows statistical difference(P <0.05).Comparison of gastric drainage volume during the three days after operation of the three groupsComparative differences between the three groups was statistically significant(F = 582.00, P < 0.01), different time difference was statistically significant(F = 1234.68, P < 0.01), and the interaction between group difference was statistically significance(F = 41.31, P < 0.01). Comparative differences between the three groups was statistically significant(F = 582.00, P < 0.01), different time difference was statistically significant(F = 1234.68, P < 0.01), and the interaction between group difference was statistically significance(F = 41.31, P < 41.31).Comparison of the occurrence of lower limb venous thrombosis after operations of the three groupsCompare the incidence of lower limb venous thrombosis after operation of the three groups. The number of lower limb venous thrombosis cases of Group 1 is 0, that of Group 2 is 1, accounting for 2.5%, and that of Group 3 is 5, accounting for 12.5%. The three groups are statistically significant(P <0.05).Comparison of urinary retention occurrence rate after operation of the three groupsCompare the three groups of patients in the occurrence of urinary retention after the operations. Group one has one case of uroschesis, occurrence rate at 2.5%. Group two has four cases with occurrence rate of 10% and Group three has nine cases with occurrence rate at 22.5%. The comparison of the three groups shows statistic differences(P <0.05).Conclusion:Early postoperative ambulation can promote the recovery of gastrointestinal functions, the earlier the ambulation is, the sooner the anal exhaust is.Early postoperative ambulation can promote the recovery of gastrointestinal functions, reduce stomach retention time, reduce gastric loss, and thus lower the probability of water electrolyte and acid-base balance.Early postoperative ambulation can promote blood circulation across the whole body, promote lower limbs venous return, and reduce the incidence of thrombus of lower extremity veins.Early postoperative ambulation can promote the recovery of bladder function, decrease the urinary retention caused by urination disorder due to urination posture change, and thus reduce the incidence of postoperative urinary retention. |
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