Activity restrictions after gynecologic surgery: is there evidence?
Activity restrictions after gynecologic surgery: is there evidence?
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DOI：
10.1007/s00192-012-2026-2
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发表时间：
2013-05-01
影响因子：
1.8
通讯作者：
Shaw, Janet M.
中科院分区：
文献类型：
--
作者：
Nygaard, Ingrid E.;Hamad, Nadia M.;Shaw, Janet M.
许多外科医生建议术后患者休息并限制活动。本综述的目的是总结有关妇科外科医生在特定活动中限制的活动类型和腹内压的文献，并概述久坐行为（休息）的负面影响。我们检索了PubMed和Scopus从1970年到现在的资料，排除了描述术后日常生活活动恢复的研究，以及由于其他原因（如腹膜间室综合征和高血压）评估腹内压力的研究。在我们对腹内压的回顾中，我们排除了没有纳入一般健康人群或没有报告最大腹内压的研究。我们没有发现任何随机试验或前瞻性队列研究来研究盆底修复术后活动与手术成功之间的关系。特定活动时的腹内压力范围很大，手术后通常受限制和不受限制的活动期间的压力重叠很大。各研究的平均腹内压力峰值几乎没有一致性。腹内压取决于许多因素，但最重要的是测量和报告的方式。鉴于住院时间缩短和下班时间间隔缩短的趋势，这两者都使妇女更容易进行高水平的体育锻炼，我们敦促开展研究工作，以了解体育锻炼在盆腔器官脱垂和手术后尿失禁复发中的作用。
Many surgeons recommend rest and restricting activities to their patients after surgery. The aim of this review is to summarize the literature regarding types of activities gynecologic surgeons restrict and intra-abdominal pressure during specific activities and to provide an overview of negative effects of sedentary behavior (rest). We searched PubMed and Scopus for years 1970 until present and excluded studies that described recovery of activities of daily living after surgery as well as those that assessed intra-abdominal pressure for other reasons such as abdominal compartment syndrome and hypertension. For our review of intra-abdominal pressure, we excluded studies that did not include a generally healthy population, or did not report maximal intra-abdominal pressures. We identified no randomized trial or prospective cohort study that studied the association between postoperative activity and surgical success after pelvic floor repair. The ranges of intra-abdominal pressures during specific activities are large and such pressures during activities commonly restricted and not restricted after surgery overlap considerably. There is little concordance in mean peak intra-abdominal pressures across studies. Intra-abdominal pressure depends on many factors, but not least the manner in which it is measured and reported. Given trends towards shorter hospital stays and off work intervals, which both predispose women to higher levels of physical activity, we urge research efforts towards understanding the role of physical activity on recurrence of pelvic organ prolapse and urinary incontinence after surgery.