深呼吸运动结合量化踝泵运动对食管癌根治术后下肢深静脉血栓形成的预防效果观察

谢芬 魏鹤群

【摘要】 目的：探討深呼吸运动结合量化踝泵运动在食管癌根治术患者中的应用价值。方法：选择2018年7月-2020年7月本院收治的行食管癌根治术患者160例，按随机数字表法将患者分为对照组（n=80）与观察组（n=80）。对照组给予常规护理干预，观察组在对照组基础上采用深呼吸运动结合量化踝泵运动，两组均干预7 d。比较两组术后下肢深静脉血栓（DVT）发生率、下肢肿胀程度、股静脉血流动力学及生活质量。结果：观察组术后DVT发生率低于对照组，下肢肿胀程度轻于对照组，干预3、7 d后股静脉峰值血流速度、平均血流速度均高于对照组，差异均有统计学意义（P<0.05）。两组干预前生理、心理、社会、环境领域评分比较，差异均无统计学意义（P>0.05）;观察组干预7 d后生理、心理、社会、环境领域评分均高于对照组，差异均有统计学意义（P<0.05）。结论：深呼吸运动结合量化踝泵运动能够增加食管癌根治术后下肢血液速度，有效预防DVT形成，减轻下肢肿胀程度，进而提高患者生活质量，值得临床推广应用。

【关键词】 食管癌根治术 深呼吸运动 量化踝泵运动 下肢深静脉血栓 生活质量

Observation on Preventive Effect of Deep Breathing Exercise Combined with Quantitative Ankle Pump Exercise on Deep Venous Thrombosis after Radical Operation of Esophageal Cancer/XIE Fen， WEI Hequn. //Medical Innovation of China， 2021， 18（27）： -114

[Abstract] Objective： To explore the application value of deep breathing exercise combined with quantitative ankle pump exercise in patients underwent radical operation of esophageal cancer. Method： A total of 160 patients underwent radical operation of esophageal cancer admitted to our hospital from July 2018 to July 2020 were selected and divided into the control group （n=80） and the observation group （n=80） according to the random number table. The control group was given routine nursing intervention， and the observation group was given deep breathing exercises combined witt quantified ankle pump exercises on the basis of the control group， and two groups were intervened for 7 d. The incidence of deep venous thrombosis （DVT）， swelling degree of lower extremities， femoral vein hemodynamics and quality of life were compared between two groups. Result： The incidence of DVT in the observation group after surgery was lower than that in the control group， and the swelling degree of lower extremities was lighter than that in the control group， the peak blood flow velocity and average blood flow velocity of femoral vein at 3 and 7 d after intervention were higher than those of the control group， the differences were statistically significant （P<0.05）. Before intervention， the scores in physical， psychological， social and environmental fields of two groups compared， the differences were not statistically significant （P>0.05）; at 7 d after intervention， the scores of physiology， psychology， society and environment in the observation group were higher than those in the control group， the differences were statistically significant （P<0.05）. Conclusion： Deep breathing exercise combined with quantified ankle pump exercise can increase the blood velocity of lower extremities after radical resection of esophageal cancer， effectively prevent the formation of DVT， reduce the degree of lower extremity swelling， and improve the quality of life of patients， it is worthy of clinical application.

[Key words] Radical resection of esophageal cancer Deep breathing exercises Quantitative ankle pump exercises Deep venous thrombosis Quality of life

First-author’s address： The Second Affiliated Hospital of Nanchang University， Nanchang 330006， China

doi：10.3969/j.issn.1674-4985.2021.27.028

食管癌属常见消化系统恶性肿瘤，其发生风险随着年龄增长而上升，多表现为吞咽食物时哽咽、吞咽困难等，对患者日常生活造成严重影响[1]。食管癌根治术是治疗食管癌的重要术式，然而术后患者长期卧床、肢体活动受限，导致下肢深静脉血栓（DVT）形成风险增加[2]。同时，食管癌根治术多经胸口入路，会引起胸腔内负压降低，影响静脉回流，加之全麻引起的周围静脉扩张，会造成静脉流速减慢，易引发DVT[3-4]。……