Research On The Application Of Evidence-Based Triple Pre Rehabilitation Strategy In Colorectal Cancer Patients

Objective Based on evidence-based approaches,a triple pre rehabilitation strategy suitable for grassroots hospitals in nutrition,exercise,and psychology is constructed to optimize the perioperative clinical pathway of Enhanced Recovery After Surgery ERAS,providing reference for perioperative care of colorectal cancer patients.Methods 1.Based on evidence,screening the research of triple pre-rehabilitation in colorectal cancer patients at home and abroad,looking for relevant evidence of triple pre-rehabilitation,and summarizing the best evidence.2.The Delphi method was used to invite 16 experts to carry out two rounds of consultation and demonstration,and to formulate the pre-rehabilitation and rehabilitation strategy of the three teams.3.The patients with colorectal tumors who met the inclusion criteria and were admitted to our hospital from April 2022 to February 2023 were selected as the study subjects.The patients were randomly divided into control group and intervention group by envelope method.The control group was given perioperative nursing according to the conventional ERAS pathway of our hospital,and the intervention group was given perioperative nursing according to the triple pre-rehabilitation strategy.The 6-minute walking distance(6MWT),anxiety and depression scores(HADS),nutritional indicators(albumin,total protein,hemoglobin),the time of first anal exhaust after operation,the time of catheter removal,the time and distance of postoperative activities,the length of hospital stay,the total cost of hospital stay,the incidence of complications and satisfaction were compared between the two groups.Results 1.A total of 3406 preliminary literature searches were conducted,and 11 were ultimately included after screening,including 1 guideline,1 expert consensus,2 meta-analyses,1 quasi experimental study,and 6 experimental studies.After screening and evaluating the quality of the included literature,a preliminary strategy for triple pre rehabilitation and rehabilitation was developed.2.After two rounds of Delphi expert correspondence,the recovery rate is 100%,Cr value is 0.804,and the professional authority is high.And formed a three-level pre-rehabilitation strategy for colorectal cancer with 3 level-I items and 12 level-Ⅱ items.3.(1)This study included 70 patients(35 in the intervention group and 35 in the control group),and there was no statistically significant difference in general clinical data,baseline values before intervention,and postoperative follow-up time between the two groups(P>0.05).(2)Before and after intervention,there were statistically significant differences within and between the 6MWT groups(P<0.05);Before and after intervention,there was a statistically significant difference in the HADS anxiety and depression scores within the group(P<0.05).There was no statistically significant difference in the HADS anxiety scores between the groups(P>0.05),while there was a statistically significant difference in the HADS depression scores between the groups(P<0.05);Before and after intervention,there was a statistically significant difference in nutritional scores within the group(P<0.05),while there was no statistically significant difference between groups(P>0.05);There was no statistically significant difference in nutritional indicators between the two groups before and after intervention(P>0.05),while there was a statistically significant difference within the group(P<0.05).(3)There was no statistically significant difference(P>0.05)between the two groups of patients in terms of postoperative gastric and urinary tube extubation time,first anal exhaust time,time to get out of bed activity,and total hospital expenses;There was a statistically significant difference(P<0.05)in the extraction time of the drainage tube,the first postoperative activity distance,hospitalization time,incidence of complications,and patient satisfaction.Conclusion The evidence-based triad pre-rehabilitation and rehabilitation pre-intervention strategy can improve the perioperative functional reserve of patients with colorectal cancer,accelerate postoperative rehabilitation,reduce the incidence of complications,and improve satisfaction,which is worthy of clinical promotion.