目的·探讨早期目标导向活动（early goal-directed mobilization，EGDM）对胰十二指肠切除术后胃肠功能恢复的有效性和安全性。方法·采用非同期对照研究，2022年9月—2023年5月选取40名胰十二指肠切除术患者为对照组，2023年6月—2024年2月选取40名胰十二指肠切除术患者为试验组。收集2组一般资料。对照组采用胰十二指肠切除术后护理常规，早期活动方面患者下床活动时间、活动目标不做具体要求。试验组在早期活动方面设置每日活动目标，指导患者及家属进行EGDM。有效性评价主要指标为术后排气排便时间；次要指标包括术后首次下床时间，首次经口饮水时间，术后胃管拔除时间，术后第3天K⁺、Na⁺、Cl^-水平。安全性评价包括乳糜漏、胰瘘、胆瘘、胃排空延迟、术后出血、非计划二次手术、非计划拔管、跌倒、死亡。结果·2组患者的一般临床资料差异均无统计学意义。相比对照组，EGDM实施后，首次排气时间由（3.95±1.68）d提前至（2.88±0.91）d（t=-3.560，P=0.001），首次排便时间由（4.90±1.61）d提前至（3.80±1.30）d（t=-3.352，P=0.001），术后首次下床时间由术后（5.18±1.77）d提前至术后（2.30±0.88）d（t=-9.205，P<0.001），首次经口饮水时间由（4.10±1.89）d提前至（2.73±1.20）d（t=-3.883，P<0.001），术后第3天Na⁺（t=-2.745，P=0.008）、Cl^-（t=-2.033，P=0.045）水平差异具有统计学意义。2组均未发生出血、非计划二次手术、非计划拔管、跌倒、死亡不良事件。结论·EGDM方案对促进胰十二指肠切除术后胃肠功能恢复是安全有效的，在术后恢复方面具有一定优势。

Objective ·To investigate the safety and feasibility of early goal-directed mobilization in the recovery of gastrointestinal function after pancreaticoduodenectomy. Methods ·The non-contemporaneous controlled studies were conducted. Subjects who underwent pancreaticoduodenectomy were included. From Sep 2022 to May 2023, forty patients were selected as the control group, and forty patients were selected from June 2023 to February 2024 as the experimental group. The general clinical data of the two groups were collected. The control group was treated with the nursing routine after pancreaticoduodenectomy, and there were no specific requirements for the time and goal of early activity. The experimental group had daily activity goals established for early mobilization, which were performed by the patients and their families, while the rest of their care was identical to that of the control group. The main index of effectiveness evaluation was the time of first flatus and first defecation, and the secondary indexes included the time of first getting out of bed, the time of oral drinking, the time of the gastric tube removal, and the postoperative levels of K⁺, Na⁺, and Cl^- on the 3rd day of the postoperative period. Safety evaluations included chyle leak, postoperative pancreatic fistula, biliary leak and delayed gastric emptying, postoperative hemorrhage, unplanned reoperation, unplanned extubation, falls and death. Results ·There was no statistically significant difference in the general clinical data of the patients in the 2 groups. After the implementation of early goal-directed mobilization, the time of first flatus was advanced from (3.95±1.68) d to (2.88±0.91) d (t=-3.560, P=0.001), and the time of first defecation was advanced from (4.90±1.61) d to (3.80±1.30) d (t=-3.352, P=0.001). The time of first getting out of bed was advanced from (5.18±1.77) d to (2.30±0.88) d (t=-9.205, P<0.001), and the time of oral drinking was advanced from (4.10±1.89) d to (2.73±1.20) d (t=-3.883, P<0.001). Significant differences were also observed in postoperative day 3 Na⁺ (t=-2.745, P=0.008) and Cl^- (t=-2.033, P=0.045) levels. Conclusion ·Early goal-directed activity programs are safe and effective in promoting the recovery of gastrointestinal function after pancreaticoduodenectomy.