基于预康复策略的家庭参与式护理对结直肠癌患者术后身体功能及心理状态的影响

周伟伟; 朱瑶瑶; 陈鸿雁; 陈昱君; 陈文静; 周晴晴

doi:10.16766/j.cnki.issn.1674-4152.004435

基于预康复策略的家庭参与式护理对结直肠癌患者术后身体功能及心理状态的影响

doi: 10.16766/j.cnki.issn.1674-4152.004435

1.
浙江中医药大学附属温州市中医院普通外科, 浙江温州 325000
2.
温州医科大学附属第一医院胃肠外科, 浙江温州 325000
3.
浙江中医药大学附属温州市中医院营养科

基金项目:

浙江省医药卫生科技计划项目 2022KY890

温州市科研项目 Y20240718

详细信息

通讯作者:
周伟伟，E-mail：15869610982@163.com

中图分类号: R735.3 R473.73
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- 文章访问数: 14
- HTML全文浏览量: 6
- PDF下载量: 1
- 被引次数: 0
出版历程
- 收稿日期: 2025-11-17
- 网络出版日期: 2026-06-02

To explore the effects of family integrated nursing based on pre-rehabilitation strategy on postoperative physical function and psychological state of patients with colorectal cancer

1.
Department of General Surgery, Wenzhou Traditional Chinese Medicine Hospital, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的探讨基于预康复策略的家庭参与式护理在结直肠癌围手术期患者中的应用效果，以促进患者术后身心康复。方法采用便利抽样法，选取2024年10月—2025年9月温州市中医院及温州医科大学附属第一医院收治的112例结直肠癌患者作为研究对象，根据随机数字表法将其分为对照组(56例)和观察组(56例)。对照组实施常规术前护理，观察组在对照组基础上实施基于预康复策略的家庭参与式护理。比较2组患者术后康复指标、运动能力、营养状况、心理状态及并发症发生情况。结果干预后，观察组首次下床活动时间、排气及排便时间分别为(1.70±0.34)d、(2.01±0.46)d、(7.13±1.19)d，均短于对照组[(2.28±0.60)d、(3.00±0.55)d、(8.94±1.23)d]，差异均有统计学意义(P＜0.05)；观察组6分钟步行实验(6MWT)高于对照组，且营养风险筛查2002(NRS2002)得分低于对照组(P＜0.05)；观察组汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)及恐惧疾病进展简化量表(FoP-Q-SF)均低于对照组(P＜0.05)。2组患者术后并发症发生率比较差异无统计学意义(χ²=2.624，P=0.105)。结论给予结直肠癌患者围手术期基于预康复策略的家庭参与式护理，有利于促进患者术后身体功能恢复，提高患者营养状态及运动能力，改善患者不良情绪。
- 结直肠癌 /
- 预康复 /
- 家庭参与式护理 /
- 心理状态 /
- 营养状态 /
- 运动能力
Abstract: Objective To evaluate the effect of family-involved care based on prehabilitation strategy during the perioperative period in patients with colorectal cancer on postoperative physical function and psychological status. Methods A convenience sampling method was used to select 112 patients with colorectal cancer admitted to Wenzhou Traditional Chinese Medicine Hospital from January 2024 to March 2025 as the study subjects. According to the random number table method, they were divided into a control group and an observation group, each consisting of 56 cases. The control group received conventional preoperative nursing, while the observation group received home-based participatory nursing based on a prehabilitation strategy in addition to the control group's treatment. The postoperative rehabilitation indicators, motor ability, nutritional status, psychological state, and complication rates were compared between the two groups. Results After the intervention, the observation group's first time to stand up, flatus passage, and defecation were (1.70±0.34) days, (2.01±0.46) days, and (7.13±1.19) days, respectively, all shorter than those of the control group (2.28±0.60) days, (3.00±0.55) days, and (8.94±1.23) days (P < 0.05). The 6-minute walk test (6MWT) in the observation group was higher than that in the control group, while the nutrition risk screening 2002 (NRS2002) score was lower (P < 0.05). The Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD), and fear of progression of disease questionnaire-short form (FoP-Q-SF) scores in the observation group were all lower than those in the control group (P < 0.05). There was no significant difference in postoperative complication rates between the two groups (χ²=2.624, P=0.105). Conclusion Preoperative home-based participatory nursing care based on a prehabilitation strategy for colorectal cancer patients facilitates postoperative physical function recovery, improves nutritional status and exercise capacity, and alleviates negative emotions.
- Colorectal cancer /
- Prehabilitation /
- Family-participatory care /
- Psychological status /
- Nutritional status /
- Exercise capacity

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表 1 2组结直肠癌患者一般资料比较

Table 1. Comparison of general data of colorectal cancer patients between the two groups

项目	对照组(n=56)	观察组(n=56)	统计量	P值
性别(例)			0.327^a	0.568
男性	30	33
女性	26	23
年龄(x±s，岁)	64.81±5.33	65.07±5.82	0.247^b	0.806
病程(x±s，月)	13.66±2.27	13.57±2.61	1.195^b	0.846
BMI(x±s)	22.08±1.26	22.12±1.57	0.149^b	0.882
照顾者(例)			0.463^a	0.496
配偶	42	45
子女	14	11
TNM分期(例)			0.976^c	0.614
Ⅰ期	11	14
Ⅱ期	18	20
Ⅲ期	27	22
疾病类型(例)			0.144^a	0.705
结肠癌	31	29
直肠癌	25	27
注：^a为χ²值，^b为t值，^c为Z值。

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表 2 2组结直肠癌患者术后康复指标比较(x±s, d)

Table 2. Comparison of postoperative rehabilitation indicators between the two groups of patients with colorectal cancer (x±s, d)

组别	例数	首次下床活动时间	首次排气时间	首次排便时间
对照组	56	2.28±0.60	3.00±0.55	8.94±1.23
观察组	56	1.70±0.34	2.01±0.46	7.13±1.19
t值		6.294	10.332	7.914
P值		＜0.001	＜0.001	＜0.001

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表 3 2组结直肠癌患者运动能力及营养状态比较(x±s)

Table 3. Comparison of exercise capacity and nutritional status between the two groups of patients with colorectal cancer (x±s)

组别	例数	6MWT(m)		NRS2002(分)
组别	例数	干预前	干预后	干预前	干预后
对照组	56	487.93±22.39	385.61±18.82	2.73±0.66	3.83±0.60
观察组	56	490.72±24.18	418.74±16.30	2.76±0.70	2.64±0.55
统计量		0.634^a	8.723^b	0.233^a	9.468^b
P值		0.528	＜0.001	0.816	＜0.001
注：^a为t值，^b为F值。

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表 4 2组结直肠癌患者心理状态比较(x±s，分)

Table 4. Comparison of psychological state between the two groups of colorectal cancer patients (x±s, score)

组别	例数	HAMA		HAMD		FoP-Q-SF
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后
对照组	56	41.34±6.17	39.55±5.70	45.29±5.77	44.82±5.16	40.29±4.15	37.34±4.71
观察组	56	40.93±7.02	34.16±4.82	45.71±6.24	40.37±4.42	39.88±4.30	30.43±3.69
统计量		0.328^a	4.924^b	0.370^a	4.871^b	0.513^a	8.035^b
P值		0.734	＜0.001	0.712	＜0.001	0.609	＜0.001
注：^a为t值，^b为F值。

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