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目的：研究早期康复训练及监测患者自理能力对肝移植术后康复的影响。方法：选择2011 年5 月至2012 年6 月在我院接受肝移植手术的患者60 例，按手术先后进行编号，使用随机排列表将患者分为实验组和对照组，每组各30 例，对照组应用常规术后宣教和护理模式，室验组应用有针对性的“肝移植术后早期康复训练计划”，并采用“自理能力监测表”对患者进行评估。分别比较两组患者的术后康复情况、睡眠和疼痛情况、术后第十日的自理能力以及术后早期并发症的发生。结果：两组患者康复情况比较，首次排气、排便、拔除尿管后首次排尿、首次下床和出院时间都有统计学差异（P<0.05）。患者睡眠和疼痛情况比较，患者每日睡眠时间增加，安眠药物使用率明显减少（P<0.05），而且术后康复训练没有增加患者术后疼痛的发生。术后第十日的自理能力比较，除自行进食（P>0.05）外，自主上下床、自主如厕和自主洗漱三个方面室验组明显比对照组好（P<0.05）。两组患者术后早期并发症的发生均无统计学差异（P>0.05）。结论：早期康复训练和自理能力监测能有效促进肝移植术后患者的康复进程。

英文摘要:

Objective:To assess the effect of early rehabilitation and monitoring of self-care ability to patients undergoing liver transplantation.Methods:60 patients undergoing liver transplantation in our hospital fromMay 2011 to June 2012 were randomly divided into two groups. Early rehabilitation training plan and monitoring of self-care ability were used in the experiment group (n=30) while routine care and health education pattern were used in the control group (n=30). Postoperative recovery, sleep, pain, self-care ability on the tenth day after operation, and early postoperative complications were compared.Results:There were significant difference between two groups in the time of first flatus, defecation, urination after catheter removal, time to ambulation and discharge(P<0.05). The patients of experiment group had more daily sleep time (P<0.05), used less hypnotics (P<0.05) and reported equivalent pain. As for the self-care ability，except self-feeding, the ability of the patients of experiment group of getting on and off of bed, independent toileting and self-washing were better(P<0.05). The early postoperative complications had no difference(P>0.05).Conclusion:Early rehabilitation and monitoring of self-care ability promote the rehabilitation process in patients undergoing liver transplantation.

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