Application of pre-hospital prerehabilitation strategy based on enhanced recovery after surgery (ERAS) concept in patients with pulmonary tumor / 中国实用护理杂志

ABSTRACT

Objective@#To explore the practical effect of pre-hospital prehabilitation strategy in pulmonary tumor patients.@*Methods@#A total of 68 patients receiving thoracic surgery in Department of Pulmonary Oncology, Tianjin Medical University Cancer Institute & Hospital, during July 2018 to April 2019, were divided into pre-hospital prehabilitation group (n=34) and control group (n=34), according to the order of outpatient. Patients in control group received routine guidance before thoracic surgery, and those in pre-hospital prehabilitation group received a home-based preoperative intervention. The differences of 6-minute walking distance (6MWD), hospital anxiety and depression score (HADS), forced expiratory volume at the first second (FEV1), forced vital capacity (FVC), postoperative thoracic drainage and complications were compared between the two groups.@*Results@#The values of 6MWD, FEV1 and FVC in the pre-hospital prehabilitation group were (611.08±47.13) m, (2.48±0.51) L and (3.43±0.48) L on one day preoperatively, respectively, while in the control group, the values were (520.26±57.33) m, (2.19±0.38) L and (3.17±0.58) L, respectively, with statistically significant differences, t=7.136, 2.659, 2.014, P<0.05. The values of 6MWD, FEV1 and FVC in the pre-hospital prehabilitation group were (540.27±85.73) m, (2.07±0.46) L and (2.98±0.67) L at 30 days postoperatively, respectively, while in the control group, the values were (488.86±75.04) m, (1.82±0.51) L and (2.42±0.58) L, respectively, with statistically significant differences, t=2.631, 2.122, 3.685, P<0.05. The thoracic drainage of pre-hospital prehabilitation group and control group were (162.35±43.08) ml and (191.42±69.11) ml, respectively, t=2.081, P<0.05. In addition, the occurrence rates of complications such as pulmonary infection, pulmonary atelectasis and arrhythmia were 0.0%(0/34), 2.9%(1/34), 0.0%(0/34) in the pre-hospital prehabilitation group, while those were 2.9%(1/34), 8.8%(3/34), 14.7%(5/34) in the control group, pre-hospital prehabilitation group had a significant reduction in the occurrence of arrhythmia (P<0.05).@*Conclusions@#The pre-hospital prehabilitation strategy significantly improve the perioperative functional status and prognosis of lung cancer patients, and reduce the occurrence of postoperative complications to a certain extent, which is worth of being further promoted clinically.