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, 陳曦, 等. 外科術后患者早期下床活動評估與應對的研究進展. 護理學雜志, 2020, 35(5): 101-105.
2.	Kuru T, Ol?ar 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, ?zer 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, 龔姝. 對腹部手術患者術后早期下床活動阻礙因素的認知調查分析. 中華現代護理雜志, 2020, 26(3): 311-315.
7.	國家衛生健康委員會醫管中心加速康復外科專家委員會器官移植學組. 中國腎移植圍手術期加速康復管理專家共識(2018版). 中華移植雜志(電子版), 2018, 12(4): 151-156.
8.	劉婷婷, 沈玲. 加速康復外科患者早期活動監測管理工具的研究進展. 護理學雜志, 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, 胡艷, 王莉, 等. 快速康復外科在親體腎移植護理中的運用. 現代預防醫學, 2013, 40(16): 3137-3140.
12.	呂露露, 張雪靜. 三級醫院ICU重癥患者早期活動現狀及障礙因素調查. 護理學雜志, 2020, 35(10): 31-34.
13.	李智, 龔姝. 加速康復外科理念下促進腹部手術患者術后早期下床活動的研究進展. 中國護理管理, 2019, 19(1): 142-145.
14.	熊曉燕, 白壽軍, 王亞琨, 等. 體能鍛煉對成人腎移植受者術后生理功能影響的Meta分析. 中華腎臟病雜志, 2018, 34(6): 424-431.
15.	Wikstr?m 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.	陳旸. 賦能健康教育對腹腔鏡膽囊切除患者術后早期下床活動的影響. 臨床醫藥文獻電子雜志, 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.	宋劍平, 盧芳燕, 吳小燕, 等. 肝切除術后患者早期活動的最佳證據應用. 中華護理雜志, 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.	雷文華, 彭文翰, 呂軍好, 等. 加速康復外科在腎移植圍手術期管理中的應用. 中華移植雜志(電子版), 2018, 12(3): 116-120.

1. 秦芳, 李秋萍, 陳曦, 等. 外科術后患者早期下床活動評估與應對的研究進展. 護理學雜志, 2020, 35(5): 101-105.
2. Kuru T, Ol?ar 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, ?zer 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, 龔姝. 對腹部手術患者術后早期下床活動阻礙因素的認知調查分析. 中華現代護理雜志, 2020, 26(3): 311-315.
7. 國家衛生健康委員會醫管中心加速康復外科專家委員會器官移植學組. 中國腎移植圍手術期加速康復管理專家共識(2018版). 中華移植雜志(電子版), 2018, 12(4): 151-156.
8. 劉婷婷, 沈玲. 加速康復外科患者早期活動監測管理工具的研究進展. 護理學雜志, 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, 胡艷, 王莉, 等. 快速康復外科在親體腎移植護理中的運用. 現代預防醫學, 2013, 40(16): 3137-3140.
12. 呂露露, 張雪靜. 三級醫院ICU重癥患者早期活動現狀及障礙因素調查. 護理學雜志, 2020, 35(10): 31-34.
13. 李智, 龔姝. 加速康復外科理念下促進腹部手術患者術后早期下床活動的研究進展. 中國護理管理, 2019, 19(1): 142-145.
14. 熊曉燕, 白壽軍, 王亞琨, 等. 體能鍛煉對成人腎移植受者術后生理功能影響的Meta分析. 中華腎臟病雜志, 2018, 34(6): 424-431.
15. Wikstr?m 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. 陳旸. 賦能健康教育對腹腔鏡膽囊切除患者術后早期下床活動的影響. 臨床醫藥文獻電子雜志, 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. 宋劍平, 盧芳燕, 吳小燕, 等. 肝切除術后患者早期活動的最佳證據應用. 中華護理雜志, 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. 雷文華, 彭文翰, 呂軍好, 等. 加速康復外科在腎移植圍手術期管理中的應用. 中華移植雜志(電子版), 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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