摘要
目的研究胸外科肺切除术后患者进行术侧肩关节康复训练的临床意义。方法选择2017年6月至2019年10月在该院胸外科接受肺切除手术治疗的患者188例,其中试验组101例,对照组87例。试验组患者由专门的康复护理人员指导,于术后第1天起进行术侧肩关节的前屈抬举和外展抬举训练,每日3次,每次15 min,直至患者出院并嘱咐患者出院后按照在医院时的训练标准继续自行居家训练。对照组患者则采取同样的术后护理及呼吸功能训练,仅口头嘱咐患者活动锻炼术侧肩关节,无特定医护人员进行床旁指导和监督。记录并比较术后第1、3、5、7天两组患者无辅助下自行抬举术侧肩关节的角度;术后2周时记录并比较两组患者一些生活自理行为的独立完成情况;术后1个月时记录并比较两组患者对于不同强度家务劳动的参与情况。结果试验组患者在术后第5、7天,术侧肩关节的前屈抬举和外展抬举角度明显大于对照组,差异均有统计学意义(P<0.05)。在术后2周时,试验组中分别有90.1%和93.1%的患者能够独立完成穿衣和梳头动作,均优于对照组,差异有统计学意义(P<0.05)。在术后1个月时,47.4%接受开胸肺手术的试验组患者能够参与家务劳动,而对照组中仅有25.0%的患者能够参与家务劳动,两组间差异有统计学意义(P<0.05)。结论胸外科肺切除手术后的患者,特别是对于开胸肺手术后的患者,在专门康复护理人员的指导和督促下进行术后早期术侧肩关节康复训练,对加快患者术侧肩关节活动能力的恢复及提高生活自理能力和劳动能力有重要意义。
Objective To study the clinical significance of operative side shoulder rehabilitation training after pneumonectomy.Methods A total of 188 patients receving pneumonectomy in the thoracic surgical department of this hospital from June 2017 to October 2019 were selected,including 101 cases in the experimental group and 87 cases in the control group.The patients in the experimental group conducted the anteflection lift and abduction lift training of shoulder joint in the operative side trained by special rehabilitation nurses on postoperative 1 d,three times a day for 15 min each time,which was until the discharge and continued to train at home according to the training standards of the hospitalization.Patients in the control group were given the same postoperative care and nursing but only oral instructions to exercise their shoulder joint,and there was no bedside guidance and supervision provided by specific medical staff.The angles of shoulder joint lift without assistance on postoperative 1,3,5,7 d were recorded and compared between the two groups.The independent completion situation of some living self-care behaviors was recorded in postoperative 2 weeks and compared between the two groups.The participation situation of different intensities of housework in postoperative 1 month was recorded and compared between the two groups.Results The angles of anteflection lift and abduction lift of the operated shoulder joints on postoperative 5,7 d in the experimental group were significantly greater than those in the control group,and the differences were statistically significant(P<0.05).In postoperative 2 weeks,90.1%and 93.1%of the patients in the experimental group were able to complete the dressing and hair brushing movements independently,which was superior to the control group,and the difference was statistically significant(P<0.05).In postoperative 1 monthly,47.4%of the patients in the experimental group receiving thoracotomy were able to participate in the housework,whereas only 25.0%of the patients in the contr
作者
卢琳
陈学瑜
LU Lin;CHEN Xueyu(Department of Thoracic Surgery,Affiliated Ruijin Hospital,School of Medicine,Shanghai Jiaotong University,Shanghai 201801,China)
出处
《检验医学与临床》
CAS
2021年第15期2204-2207,共4页
Laboratory Medicine and Clinic
关键词
肩关节
康复训练
肺手术
shoulder joint
rehabilitation training
pulmonary surgery
