摘要
目的验证喉癌颈淋巴清扫术后患者预防性康复锻炼对于改善肩功能的效果。方法非同期对照类实验设计,将76例喉癌手术同期行颈淋巴清扫患者按时间先后分为对照组和观察组,每组38例。对照组接受头颈外科常规护理(无肩功能康复锻炼),观察组接受早期预防性肩功能康复锻炼,术后3个月、6个月时采用Constant-Murley肩功能评分测评两组肩功能状况。结果术后3个月时两组患者肩功能评分均较术前下降,至术后6个月时,两组肩功能评分均呈现上升趋势。两组肩功能主观评分及客观评分的时间效应存在统计学差异(均P<0.01),组间效应、时间与组间的交互效应无统计学差异(均P>0.05)。结论喉癌颈淋巴清扫术后早期预防性肩颈康复锻炼的效果有限,肩功能呈现自我恢复趋势,在更充分证据产生之前,不建议临床常规开展预防性康复锻炼。
Objective To validate the effectiveness of prophylactic shoulder exercises on improving shoulder function in patients with laryngeal cancer undergoing neck dissection. Methods A quasi-experimental study was used. A total of 76 laryngeal cancer patients after neck dissection were divided into a control group and an observation group chronologically, with 38 in each group. Patients in the control group received routine care without shoulder exercise, while their counterparts in the observation group received early prophylactic shoulder exercises. Shoulder function was measured by the Constant-Murley score at 3 and 6 months postoperatively. Results Shoulder function in both groups decreased at 3 months postoperatively compared to baseline and improved at 6 months postoperatively. Repeated measures ANOVA revealed a significant time effect in the subjective and objective scores of shoulder function（P〈0.01 for both）, but no significant group effect or group by time interaction effect （P〉0.05 for all）. Conclusion Early prophylactic shoulder exercise is not so effective in improving shoulder recovery in patients with laryngeal cancer after neck dissec- tion and shoulder function gradually recovers with time. Prophylactic shoulder exercise is not recommended for clinical practice un- less sufficient evidence is adduced.
作者
吴沛霞
陈君仪
周苹
彭峥嵘
Wu Peixia Chen Junyi Zhou Ping Peng Zhengrong(Operating Room, Eye ＆ ENT Hospital of Fudan University, Shanghai 200031 , China)
出处
《护理学杂志》
CSCD
2017年第14期91-94,共4页
Journal of Nursing Science
基金
上海市卫生局科研基金资助项目(20134y161)
复旦大学护理学院科研基金资助项目(FNF201231)
关键词
喉癌
颈淋巴清扫术
康复锻炼
肩功能
laryngeal cancer
neck dissection
rehabilitation exercise
shoulder function
