术前运动对脑室-腹腔分流术患者的效果

doi:10.3969/j.issn.1006-9771.2025.08.012

Abstract

Abstract:

Objective To observe the effect of preoperative exercise on consciousness, lung function and recovery efficiency of patients undergoing ventriculoperitoneal shunt.

Methods A total of 54 patients undergoing elective ventriculoperitoneal shunt in Beijing Bo'ai Hospital from October, 2024 to March, 2025 were randomly divided into control group (n = 27) and prerehabilitation group (n = 27). The control group received routine preoperative treatment and nursing, while the prerehabilitation group additionally received exercise for two weeks. They were assessed with Coma Recovery Scale-Revised (CRS-R), and observed diaphragm mobility with sonography, before and three days after operation; and the time to first ambulation after surgery and length of stay in hospital were compared between two groups.

Results CRS-R scores improved in both groups after operation (|t| > 5.451, P < 0.001), and it was greater in the prehabilitation group than in the control group (t = 2.812, P < 0.01). CRS-R subscale scores improved in auditory and motor functions in the control group (|Z| > 2.000, P < 0.05), and they were improved in auditory, visual, motor, verbal and arousal functions in the prehabilitation group (|Z| > 2.282, P < 0.01). CRS-R subscale scores were greater in motor and arousal in the prehabilitation group than in the control group (|Z| > 2.320, P < 0.05). Diaphragmatic mobility improved in the prehabilitation group (t = -7.782, P < 0.001), and it was better than in the control group (t = 2.044, P < 0.05). The time to first ambulation after surgery and length of stay in hospital were shorter in the prehabilitation group than in the control group (|t| > 3.654, P < 0.01).

Conclusion Preoperative exercise for patients undergoing elective ventriculoperitoneal shunt can improve the consciousness after operation, especially the level of motor and arousal, as well as the lung function, and accelerate the recovery process.

Key words: ventriculoperitoneal shunt, preoperative exercise, prehabilitation

CLC Number:

R651.1

LÜ Xueqin, ZHANG Tong, LIU Huilin, LIU Jianhua, LI Da, WANG Huawei. Effect of preoperative exercise on patients undergoing ventriculoperitoneal shunt[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(8): 958-964.

Figures/Tables 5

Table 1

Table 2

Comparison of total scores of CRS-R between two groups"

组别	n	测试	$x - ± s$	t值	P值
对照组	27	前测	5.30±1.86	-5.451	< 0.001
		后测	6.19±1.49
预康组	27	前测	4.63±1.74	-16.189	< 0.001
		后测	7.44±1.78
前测两组均值差			0.67±0.49	-1.363	0.179
后测两组均值差			-1.26±0.45	2.812	0.007

Table 2

Table 3

Table 4

Comparison of diaphragmatic excursion between two groups 单位：cm"

组别	n	测试	$x - ± s$	t值	P值
对照组	27	前测	1.33±0.29	0.727	0.474
		后测	1.33±0.27
预康组	27	前测	1.32±0.26	-7.782	< 0.001
		后测	1.47±0.25
前测两组均值差			0.01±0.07	-0.195	0.846
后测两组均值差			-0.14±0.07	2.044	0.046

Table 4

Table 5

Comparison of time to first ambulation after surgery and length of stay in hospital between two groups"

变量	组别	n	$x - ± s$	t值	P值
术后首次下床时间/h	对照组	27	33.19±4.67	-3.654	0.001
	预康组	27	28.81±4.10
住院时间/d	对照组	27	52.52±3.57	-6.123	< 0.001
	预康组	27	47.67±2.06

Table 5

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组别	n	性别(男/女)/n	年龄/岁	病程/d	GCS
对照组	27	16/11	44.33±10.10	94.00±4.45	7(6,8)
预康组	27	15/12	46.89±8.28	102.78±4.44	6(5,7)
χ²/t/Z值		0.076	1.016	1.396	-1.690
P值		0.783	0.314	0.169	0.091

子量表	组别	n	测试	M(Q_L, Q_U)	Z值	P值
听觉	对照组	27	前测	1(1, 1)	-2.000	0.046
			后测	1(1, 1)
	预康组	27	前测	1(0, 1)	-3.464	0.001
			后测	1(1, 2)
	前测两组差值			0(-1, 0)	-0.999	0.318
	后测两组差值			0(0, 1)	-1.044	0.297
视觉	对照组	27	前测	1(1, 1)	0.000	1.000
			后测	1(1, 1)
	预康组	27	前测	1(0, 1)	-2.282	0.005
			后测	1(1, 1)
	前测两组差值			0(-1, 0)	-0.708	0.479
	后测两组差值			0(0, 1)	-1.134	0.257
运动	对照组	27	前测	1(1, 2)	-3.464	0.001
			后测	2(1, 2)
	预康组	27	前测	1(1, 1)	-4.130	< 0.001
			后测	2(2, 2)
	前测两组差值			0(-1, 0.5)	-0.463	0.643
	后测两组差值			0(0, 1)	-2.849	0.004
语言	对照组	27	前测	0(0, 1)	-1.000	0.317
			后测	0(0, 1)
	预康组	27	前测	0(0, 1)	-3.464	0.001
			后测	1(1, 1)
	前测两组差值			0(-1, 0.5)	-0.595	0.552
	后测两组差值			0(0, 1)	-1.876	0.061
交流	对照组	27	前测	0(0, 0)	0.000	1.000
			后测	0(0, 0)
	预康组	27	前测	0(0, 0)	0.000	1.000
			后测	0(0, 0)
	前测两组差值			0(0, 0)	-1.030	0.303
	后测两组差值			0(0, 0)	-1.030	0.303
唤醒度	对照组	27	前测	1(1, 2)	-1.604	0.109
			后测	2(1, 2)
	预康组	27	前测	1(1, 2)	-4.185	< 0.001
			后测	2(2, 3)
	前测两组差值			0(-1, 0)	-0.621	0.534
	后测两组差值			0(0, 1)	-2.320	0.020

Effect of preoperative exercise on patients undergoing ventriculoperitoneal shunt

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