DYNAMICS OF THE LEVEL OF FUNCTIONING OF ELDERLY PATIENTS AFTER LAPAROSCOPIC CHOLECYSTECTOMY IN THE POST-ACUTE PERIOD OF REHABILITATION

Abstract

Abstract. Topicality. Scientists point out that there is a share of patients after LHC who have the so-called postcholecystectomy syndrome and need rehabilitation intervention, but with a large number of cholecystectomies performed annually in Ukraine and the world, it becomes clear that this issue remains relevant for many patients. The goal of the work to determine the dynamics of the level of functioning of elderly patients after laparoscopic cholecystectomy in the post-acute period of rehabilitation. The task: to determine the effectiveness of the developed rehabilitation program and its impact on the level of functioning. To conduct a comparative analysis of the levels of functioning between groups of patients with chronic calculous cholecystitis (CCC) and acute calculous cholecystitis (ACC). Materials and methods. The study included elderly patients aged 60 to 74 years with CKD (n=40), including men (n=9) and women (n=31) and patients with CKD (n=40), including men (n= 9) and women (n=31) who underwent LCT. The study is simple, randomized by a simple random sampling method. Patients with CKD: control group (CG1) and main group (OG1); from GKH: KG2 and OG2. OG1 and OG2 patients receive rehabilitation according to our methodology using a biopsychosocial approach at the subacute stage of rehabilitation. A survey was conducted on the presence of violations of functioning, activity and participation using the ICF. Statistical analysis. Calculations included measurements of the median value (Me), upper and lower quartiles (25%; 75%). The Mann-Whitney U-test was used to compare independent samples, the Wilcoxon T-test was used for dependent samples, differences at p<0.05 were considered statistically significant. Research results: Analyzing the results of patients after LHC before the start of rehabilitation intervention in the post-acute period of rehabilitation, patients of all groups had sleep disorders; emotions, disturbances in the work of the gastrointestinal tract and the feeling of pain, disturbances in the function of balance and movement, the feeling of pain, a decrease in the function of breathing, tolerance to physical exertion, general physical endurance, a decrease in the strength of the muscles of the trunk, the function of muscle endurance, low tolerance to physical exertion and weakness of muscle groups, etc. Conclusions. In the post-acute period of rehabilitation after cholecystectomy, the use of diet and postoperative symptomatic medical support has a positive effect on the feeling of pain in the stomach or abdomen, defecation functions, flatulence, nausea, and bloating. The OG1 and OG2 rehabilitation technique, which was based on the use of ICF and the achievement of long- and short-term goals with a patient-centered approach, in combination with symptomatic medical support, can affect the achievement of improvement not only in the optimal level of gastrointestinal functions, but also in improving activity and participation.Key words: rehabilitation, functioning, physical therapy, cholecystectomy.