Observation on the effect of early rehabilitation training post operation in renal transplantation recipients_West China Medical Journal

Authors：

LI Guo ^1,2 , ZHAO Shangping ³ , WANG Miaowei ^1,2 , ZHANG Xia ^1,2 ,  HE Chengqi ^1,2

1. Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. The 3rd General Ward, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

HE Chengqi, Email: hxkfhcq@126.com

Keywords：

Renal transplantation recipient; Rehabilitation training; Early exercise; Postoperative pain; Postoperative infection

DOI：

10.7507/1002-0179.202103031

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Objective To explore the effect of rehabilitation training focusing on early exercise on the time of first getting out of bed after surgery, pain during early activities, postoperative infection rate and the length of hospital stay for renal transplant recipients.Methods The clinical data of patients undergoing allogeneic renal transplantation in West China Hospital of Sichuan University from June to August 2020 were analyzed retrospectively. According to the time of multidisciplinary postoperative management and the time of early rehabilitation intervention, the patients were divided into the conventional group (from June 2020 to the beginning of multidisciplinary postoperative management) and the rehabilitation group (after multidisciplinary postoperative management). The time to get out of bed for the first time after surgery, the Visual Analogue Score (VAS) during weight monitoring on the second day post operation, the number of days required to complete an independent walk of 100 meters, postoperative complications, the incidence of postoperative infection and the length of hospital stay were compared between the two groups.Results A total of 79 patients were included. There were 46 cases in the conventional group and 33 cases in the rehabilitation group. Among the included patients, 14 patients had postoperative infection, 1 patients in the conventional group developed thrombosis, no catheter shedding or bleeding after exercise occurred. The differences between the rehabilitation group and the conventional group in the time to get out of bed for the first time after surgery [(1.1±0.2) vs. (2.2±0.4) d; t=13.224, P<0.001], the VAS during weight monitoring on the day post operation (2.5±0.9 vs. 3.4±1.4; t=3.267, P<0.001), the number of days required to complete an independent walk of 100 meters [(2.2±0.4) vs. (4.0±0.8) d; t=11.312, P<0.001], and the incidence of postoperative infection (6.1% vs. 26.1%; χ²=5.285, P=0.022) were statistically significant. There was no significant difference in the length of stay between the rehabilitation group and the conventional group [(19.8±5.8) vs. (20.7±7.4) d; t=0.584, P=0.561].Conclusion Early postoperative rehabilitation training reduces the time required for renal transplant recipients to get out of bed for the first time post operation and to walk 100 meters independently, reduce the pain response during early activities, and reduce the incidence of postoperative infection.

Citation： LI Guo, ZHAO Shangping, WANG Miaowei, ZHANG Xia, HE Chengqi. Observation on the effect of early rehabilitation training post operation in renal transplantation recipients. West China Medical Journal, 2021, 36(5): 578-581. doi: 10.7507/1002-0179.202103031 Copy

1.	秦芳, 李秋萍, 陈曦, 等. 外科术后患者早期下床活动评估与应对的研究进展. 护理学杂志, 2020, 35(5): 101-105.
2.	Kuru T, Olçar HA. Effects of early mobilization and weight bearing on postoperative walking ability and pain in geriatric patients operated due to hip fracture: a retrospective analysis. Turk J Med Sci, 2020, 50(1): 117-125.
3.	Balvardi S, Pecorelli N, Castelino T, et al. Impact of facilitation of early mobilization on postoperative pulmonary outcomes after colorectal surgery: a randomized controlled trial. Ann Surg, 2020, 273(5): 868-875.
4.	Yayla A, Özer N. Effects of early mobilization protocol performed after cardiac surgery on patient care outcomes. Int J Nurs Pract, 2019, 25(6): e12784.
5.	Tsuboi N, Hiratsuka M, Kaneko S, et al. Benefits of early mobilization after pediatric liver transplantation. Pediatr Crit Care Med, 2019, 20(2): e91-e97.
6.	李梅霞, 李智, 龚姝. 对腹部手术患者术后早期下床活动阻碍因素的认知调查分析. 中华现代护理杂志, 2020, 26(3): 311-315.
7.	国家卫生健康委员会医管中心加速康复外科专家委员会器官移植学组. 中国肾移植围手术期加速康复管理专家共识(2018版). 中华移植杂志(电子版), 2018, 12(4): 151-156.
8.	刘婷婷, 沈玲. 加速康复外科患者早期活动监测管理工具的研究进展. 护理学杂志, 2019, 34(10): 25-29.
9.	Campanati-Palhares L, Simoncini TC, da Silva Augusto PG, et al. Effects of a physiotherapeutic protocol in respiratory function, aerobic capacity and quality of life after kidney transplantation. Transplant Proc, 2018, 50(3): 750-753.
10.	Dias BH, Rana AAM, Olakkengil SA, et al. Development and implementation of an enhanced recovery after surgery protocol for renal transplantation. ANZ J Surg, 2019, 89(10): 1319-1323.
11.	谷波, 胡艳, 王莉, 等. 快速康复外科在亲体肾移植护理中的运用. 现代预防医学, 2013, 40(16): 3137-3140.
12.	吕露露, 张雪静. 三级医院ICU重症患者早期活动现状及障碍因素调查. 护理学杂志, 2020, 35(10): 31-34.
13.	李智, 龚姝. 加速康复外科理念下促进腹部手术患者术后早期下床活动的研究进展. 中国护理管理, 2019, 19(1): 142-145.
14.	熊晓燕, 白寿军, 王亚琨, 等. 体能锻炼对成人肾移植受者术后生理功能影响的Meta分析. 中华肾脏病杂志, 2018, 34(6): 424-431.
15.	Wikström L, Nilsson M, Eriksson K. The association of patients’ daily summarized self-rated “real-time” pain scores with physical recovery after major surgery-a repeated measurement design. Nurs Open, 2019, 7(1): 307-318.
16.	Xu XY, Lu JL, Xu Q, et al. Risk factors and the utility of three different kinds of prediction models for postoperative fatigue after gastrointestinal tumor surgery. Support Care Cancer, 2021, 29(1): 203-211.
17.	陈旸. 赋能健康教育对腹腔镜胆囊切除患者术后早期下床活动的影响. 临床医药文献电子杂志, 2020, 7(4): 94-95, 97.
18.	Othman N, Gheith O, Al-Otaibi T, et al. Role of diabetes education program in controlling posttransplant diabetes in a recent renal transplant bodybuilder: case report and review of the literature. Exp Clin Transplant, 2019, 17(Suppl 1): 169-171.
19.	Zelle DM, Klaassen G, van Adrichem E, et al. Physical inactivity: a risk factor and target for intervention in renal care. Nat Rev Nephrol, 2017, 13(5): 318.
20.	宋剑平, 卢芳燕, 吴小燕, 等. 肝切除术后患者早期活动的最佳证据应用. 中华护理杂志, 2019, 54(8): 1175-1179.
21.	Calotta NA, Coon D, Bos TJ, et al. Early ambulation after colorectal oncologic resection with perineal reconstruction is safe and effective. Am J Surg, 2019, 218(1): 125-130.
22.	雷文华, 彭文翰, 吕军好, 等. 加速康复外科在肾移植围手术期管理中的应用. 中华移植杂志(电子版), 2018, 12(3): 116-120.

1. 秦芳, 李秋萍, 陈曦, 等. 外科术后患者早期下床活动评估与应对的研究进展. 护理学杂志, 2020, 35(5): 101-105.
2. Kuru T, Olçar HA. Effects of early mobilization and weight bearing on postoperative walking ability and pain in geriatric patients operated due to hip fracture: a retrospective analysis. Turk J Med Sci, 2020, 50(1): 117-125.
3. Balvardi S, Pecorelli N, Castelino T, et al. Impact of facilitation of early mobilization on postoperative pulmonary outcomes after colorectal surgery: a randomized controlled trial. Ann Surg, 2020, 273(5): 868-875.
4. Yayla A, Özer N. Effects of early mobilization protocol performed after cardiac surgery on patient care outcomes. Int J Nurs Pract, 2019, 25(6): e12784.
5. Tsuboi N, Hiratsuka M, Kaneko S, et al. Benefits of early mobilization after pediatric liver transplantation. Pediatr Crit Care Med, 2019, 20(2): e91-e97.
6. 李梅霞, 李智, 龚姝. 对腹部手术患者术后早期下床活动阻碍因素的认知调查分析. 中华现代护理杂志, 2020, 26(3): 311-315.
7. 国家卫生健康委员会医管中心加速康复外科专家委员会器官移植学组. 中国肾移植围手术期加速康复管理专家共识(2018版). 中华移植杂志(电子版), 2018, 12(4): 151-156.
8. 刘婷婷, 沈玲. 加速康复外科患者早期活动监测管理工具的研究进展. 护理学杂志, 2019, 34(10): 25-29.
9. Campanati-Palhares L, Simoncini TC, da Silva Augusto PG, et al. Effects of a physiotherapeutic protocol in respiratory function, aerobic capacity and quality of life after kidney transplantation. Transplant Proc, 2018, 50(3): 750-753.
10. Dias BH, Rana AAM, Olakkengil SA, et al. Development and implementation of an enhanced recovery after surgery protocol for renal transplantation. ANZ J Surg, 2019, 89(10): 1319-1323.
11. 谷波, 胡艳, 王莉, 等. 快速康复外科在亲体肾移植护理中的运用. 现代预防医学, 2013, 40(16): 3137-3140.
12. 吕露露, 张雪静. 三级医院ICU重症患者早期活动现状及障碍因素调查. 护理学杂志, 2020, 35(10): 31-34.
13. 李智, 龚姝. 加速康复外科理念下促进腹部手术患者术后早期下床活动的研究进展. 中国护理管理, 2019, 19(1): 142-145.
14. 熊晓燕, 白寿军, 王亚琨, 等. 体能锻炼对成人肾移植受者术后生理功能影响的Meta分析. 中华肾脏病杂志, 2018, 34(6): 424-431.
15. Wikström L, Nilsson M, Eriksson K. The association of patients’ daily summarized self-rated “real-time” pain scores with physical recovery after major surgery-a repeated measurement design. Nurs Open, 2019, 7(1): 307-318.
16. Xu XY, Lu JL, Xu Q, et al. Risk factors and the utility of three different kinds of prediction models for postoperative fatigue after gastrointestinal tumor surgery. Support Care Cancer, 2021, 29(1): 203-211.
17. 陈旸. 赋能健康教育对腹腔镜胆囊切除患者术后早期下床活动的影响. 临床医药文献电子杂志, 2020, 7(4): 94-95, 97.
18. Othman N, Gheith O, Al-Otaibi T, et al. Role of diabetes education program in controlling posttransplant diabetes in a recent renal transplant bodybuilder: case report and review of the literature. Exp Clin Transplant, 2019, 17(Suppl 1): 169-171.
19. Zelle DM, Klaassen G, van Adrichem E, et al. Physical inactivity: a risk factor and target for intervention in renal care. Nat Rev Nephrol, 2017, 13(5): 318.
20. 宋剑平, 卢芳燕, 吴小燕, 等. 肝切除术后患者早期活动的最佳证据应用. 中华护理杂志, 2019, 54(8): 1175-1179.
21. Calotta NA, Coon D, Bos TJ, et al. Early ambulation after colorectal oncologic resection with perineal reconstruction is safe and effective. Am J Surg, 2019, 218(1): 125-130.
22. 雷文华, 彭文翰, 吕军好, 等. 加速康复外科在肾移植围手术期管理中的应用. 中华移植杂志(电子版), 2018, 12(3): 116-120.

West China Medical Journal

Observation on the effect of early rehabilitation training post operation in renal transplantation recipients

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