Inclusion of the prepared patient relatives in the process of early rehabilitation of onco-surgical patients in the department of anesthesiology and intensive care

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Abstract


Aim. To study the influence of the trained environment of geriatric onco-surgical patients on the quality of the interventions in the complex of early postoperative rehabilitation in the Intensive Care Unit (ICU).

Methods. The 96 patients aged 73.3±7.1 years operated on in the emergency onco-surgery clinic of the Tatarstan Cancer Center of the Ministry of Health of the Republic of Tatarstan between 2016 and 2020. Patients, similar in age and condition (American Society of Anaesthesiologists’ Physical Status category IIIE) were divided into three equal groups: the first group — generally accepted measures for early rehabilitation were carried out by medical staff; the second group — the prepared relatives of the patient was additionally involved in rehabilitation; the control group — early rehabilitation was not carried out. The quality of nutritional support and measures to prevent pressure ulcers, cognitive function were assessed. Statistical processing was performed by using Microsoft Excel 2007 and IBM SPSS Statistics version 20 software. The statistical significance of data was determined by using the chi-square test at p <0.05.

Results. The involvement of previously trained relatives made it possible to reduce the incidence of pressure ulcers grade IV to 0%. There was a significant difference in the volume of assimilated enteral oral feeding (180.6±20.8; 240.6±20.8; 80.5±10.2; p <0.05) and the serum albumin level by 11 days after surgery (26.8±1.5; 28.9±1.2; 24.2±1.1 g/L, respectively; p <0.05). Assimilation of enteral oral feeding improved 3 times compared with the control group and 1.5 times compared with the first group (p <0.05). Indicators of cognitive status by the Mini Mental State Examination (MMSE) on the 6th day were 23.3±1.1; 25.3±1.1; 21.2±1.2 (p <0.05), respectively.

Conclusion. A rationally organized preparation of the patient's environment for the implementation of care, parti­cipation in rehabilitation measures and the prevention of complications can improve outcomes of medical intervention and reduce the incidence of postoperative complications.


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About the authors

A K Saetgaraev

Kazan State Medical University; Tatarstan Cancer Center

Email: maximovigor@mail.ru

Russian Federation, Kazan, Russia; Kazan, Russia

I L Maximov

Kazan State Medical University

Author for correspondence.
Email: maximovigor@mail.ru

Russian Federation, Kazan, Russia

I I Zakirov

Kazan State Medical University; Children's Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan

Email: maximovigor@mail.ru

Russian Federation, Kazan, Russia; Kazan, Russia

I V Shaymardanov

Tatarstan Cancer Center

Email: maximovigor@mail.ru

Russian Federation, Kazan, Russia

I A Grigoreva

Kazan State Medical University

Email: maximovigor@mail.ru

Russian Federation, Kazan, Russia

M E Guryleva

Kazan State Medical University

Email: maximovigor@mail.ru

Russian Federation, Kazan, Russia

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Supplementary files

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1.
Рис. 1. Динамика изменений уровня альбумина в пред- и послеоперационном периодах

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Рис. 2. Динамика изменений индекса когнитивной функции по краткой шкале оценки психического статуса в трёх наблюдаемых группах до операции и в после­операционном восстановительном периоде

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© 2021 Saetgaraev A.K., Maximov I.L., Zakirov I.I., Shaymardanov I.V., Grigoreva I.A., Guryleva M.E.

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