在结肠癌手术后虚弱的患者的优化离院后护理 (ERAS® 3.0项目):随机对照试验的协议
Elna A Dalsgaard1, Troels G Dolin2, Cecilia M Lund3
1Centre for Perioperative Optimization, Department of Surgery, Copenhagen University Hospital, Herlev and Gentofte, Herlev, Denmark; Dietitians and Nutritional Research Unit, EATEN, Copenhagen University Hospital, Herlev and Gentofte, Herlev, Denmark.
Journal of geriatric oncology
|June 24, 2025
概括
这项研究测试了一项新的手术后增强恢复 (ERAS®) 3.0计划,为脆弱结肠癌患者提供家庭支持. 干预改善了手术后的康复质量和功能结果.
科学领域:
- 老年医学 老年医学
- 手术瘤学手术瘤学
- 营养科学 营养科学
背景情况:
- 结肠癌的发病率随着年龄的增长而上升,需要手术切除.
- 脆弱的患者面临更高的手术并发症和不良康复风险.
- 手术后强化康复 (ERAS®) 途径改善了医院内康复,但出院后的支持缺乏,导致再入院率高.
研究的目的:
- 评估ERAS® 3.0计划的效果,包括家庭 Geriatric,营养和运动干预措施,对虚弱结肠癌患者退院后的康复.
- 评估这个综合计划能否减少并发症,提高功能恢复和生活质量.
- 通过解决出院后的需求,将ERAS®原则扩展到住院之外.
主要方法:
- 一项随机对照试验,涉及60名结肠癌患者,他们在ERAS®途径内接受选择性结肠切除.
- 患有虚弱 (临床虚弱度表4-7) 和营养风险的患者随机分配到ERAS® 3.0干预组 (n=30) 或标准护理组 (n=30).
- 干预包括蛋白质丰富的食物,家庭 Geriatric 评估,饮食咨询,运动说明和门诊随访. 主要结局是恢复质量的变化-15分.
主要成果:
- 该研究旨在测量恢复质量-15分数的变化,作为主要结果.
- 二次结果包括生活质量,日常生活活动,营养摄入量,身体功能 (30秒椅站测试),肌肉质量,住院时间,再入院率,并发症,死亡率和成本.
- 患者报告的结果措施将提供全面的康复评估.
结论:
- 该ERAS® 3.0计划旨在优化外科手术后的护理,以治疗虚弱的患者.
- 结合家庭 Geriatric,营养和运动干预措施可以减少并发症,改善功能恢复和生活质量.
- 这种方法可以提供一种有价值的策略,以加强医院之外的康复.
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