基于老年综合评估的预康复在术前衰弱老年肺癌病人中的应用

doi:10.3969/j.issn.1003-9198.2024.11.015

Abstract

Abstract: Objective To explore the effect of prehabilitation based on comprehensive geriatric assessment (CGA) in the elderly patients with lung cancer combined with preoperative frailty. Methods A total of 88 elderly patients with lung cancer combined with preoperative frailty were randomly divided into two groups, with 44 cases in each group. The control group received routine nursing, while the observation group received prehabilitation based on CGA before surgery additionally. The postoperative recovery, physical function, nutritional status and psychological status were assessed and compared between the two groups. Results A total of 43 patients in the observation group and 42 patients in the control group completed the study. The first time of getting out of bed, thoracic drainage tube retention time, amount of drainage fluid, postoperative hospital stay, the score of 15-item Quality of Recovery Scale on the 3rd day after surgery, the levels of forced expiratory volume in the first second(FEV1), forced vital capacity(FVC) on the 30th day after surgery and postoperative complications in 30 days in the observation group were significantly better than those in the control group (P＜0.05). 30 days after surgery, grip strength, walking speed, the levels of blood albumin, prealbumin and hemoglobin in the observation group were significantly higher than those in the control group. The scores of the Hospital Anxiety and Depression Scale in the observation group were significantly lower than those in the control group (all P<0.05). Conclusions Prehabilitation based on CGA is beneficial for perioperative management of the elderly patients with lung cancer combined with frailty, which can promote postoperative recovery.

Key words: comprehensive geriatric assessment, prehabilitation, frailty, lung cancer, aged

CLC Number:

LIU Caiyun, HUO Xiaopeng, LIU Xiaoxuan, YAN Li, LI Wei, HE Zhijuan. Application of prehabilitation based on comprehensive geriatric assessment in elderly patients with lung cancer combined with preoperative frailty[J]. Practical Geriatrics, 2024, 38(11): 1153-1157.

References

[1] CESARI M, CALVANI R, MARZETTI E. Frailty in older persons[J]. Clin Geriatr Med, 2017, 33(3): 293-303.
[2] 郭科迪,武岩,汤夕慧,等.术前衰弱对老年肺癌患者术后并发症的影响[J].实用医学杂志,2023,39(15):1956-1960.
[3] 中华医学会老年医学分会,陈旭娇,严静,等.老年综合评估技术应用中国专家共识[J].中华老年医学杂志,2017,36(5):471-477.
[4] 吴敏婕,吴申慧,严玉茹. 老年综合评估在老年衰弱群体中的应用现状及思考[J]. 中国全科医学,2023,26(13):1655-1660.
[5] 夏萍,殷柳梅,袁玲,等.术前预康复护理方案在肺癌胸腔镜手术患者中的应用研究[J].重庆医学,2023,52(2):245-249.
[6] FRIED L P, TANGEN C M, WALSTON J, et al. Frailty in older adults: evidence for a phenotype[J]. J Gerontol A Biol Sci Med Sci, 2001, 56(3):M146-M156.
[7] KONDRUP J, RASMUSSEN H H, HAMBERG O, et al. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials[J]. Clin Nutr, 2003, 22(3):321-336.
[8] ELLUL J, BARER D. On behalf of ESDB/COSTAR collaborative dysphagia study: interobserver reliability of a standardized swallowing assessment[J]. Cerebrovas Dis,1996, 6(2): 152-153.
[9] ZIGMOND A S, SNAITH R P. The hospital anxiety and depression scale[J]. Acta Psychiatr Scand, 1983, 67(6): 361-370.
[10] FOLSTEIN M F, FOLSTEIN S E, MCHUGH P R. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician[J]. J Psychiatr Res, 1975, 12(3): 189-198.
[11] 中华医学会老年医学分会. 老年患者衰弱评估与干预中国专家共识[J]. 中华老年医学杂志,2017,36(3):251-256.
[12] 中华医学会老年医学分会,75岁及以上稳定性冠心病患者运动康复中国专家共识写作组. 75岁及以上稳定性冠心病患者运动康复中国专家共识[J]. 中国综合临床,2018,34(2):97-104.
[13] 中华医学会肠外肠内营养学分会,中国医药教育协会加速康复外科专业委员会. 加速康复外科围术期营养支持中国专家共识(2019版)[J]. 中华消化外科杂志,2019,18(10):897-902.
[14] STARK P A, MYLES P S, BURKE J A. Development and psychometric evaluation of a postoperative quality of recovery score: the QoR-15[J]. Anesthesiology, 2013, 118(6):1332-1340.
[15] CLAVIEN P A, BARKUN J, DE OLIVEIRA M L, et al. The clavien-dindo classification of surgical complications: five-year experience[J]. Ann Surg, 2009, 250(2):187-196.
[16] 陈萍萍,金宗兰,陈梅霞,等. 老年综合评估模式在老年前列腺增生病人衰弱管理中的应用[J]. 实用老年医学,2020,34(4):394-397.
[17] DWORSKY J Q, CASTLE S C, LEE C C, et al. Gerofit prehabilitation pilot program: preparing frail older veterans for surgery[J]. J Healthc Qual, 2019, 41(2):91-98.
[18] 曹亭,刘启帆,施月仙,等. 运动联合营养支持对衰弱期及衰弱前期老年人影响的Meta分析[J]. 中国护理管理,2019,19(1):52-59.

Application of prehabilitation based on comprehensive geriatric assessment in elderly patients with lung cancer combined with preoperative frailty

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