多元化康复训练体系在甲状腺癌行颈淋巴结清扫术后患者中的应用  

Application of diversified rehabilitation training system in patients with thyroid cancer after neck dissection

作　　者：金舒静 朱丽娟[1] 蒋金秋 袁玮媚 高慧琳 方芳[1] 陈歆维[1] 査怡鑫 徐梅 JIN Shujing;ZHU Lijuan;JIANG Jinqiu;YUAN Weimei;GAO Huilin;FANG Fang;CHEN Xinwei;ZHA Yixin;XU Mei(Shanghai General Hospital,of Shanghai Jiaotong University school of medicine,Shanghai,200086,China)

机构地区：[1]上海交通大学附属第一人民医院耳鼻咽喉头颈外科,200086

出　　处：《中国中西医结合耳鼻咽喉科杂志》2022年第4期309-313,共5页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的探讨多元化康复训练体系在甲状腺癌行颈淋巴结清扫术后患者中应用对颈肩功能的影响。方法选取2018年5月~2019年11月期间在上海某三甲医院行甲状腺癌切除术及择区淋巴结清扫术的120例患者为研究对象,按时间先后各入组40例患者为对照组、观察组1和观察组2。对照组行常规宣教护理,观察组2实施多元化康复训练体系,观察组1较观察组2减少住院期间的低频电疗,评估三组患者在术后第1天、第2天、第3天、1周、1月以及3月的疼痛评分情况,第1周、1月以及3月颈肩功能情况,1月以及3月颈部僵硬情况的差异。结果肩功能评分总分及日常生活活动、肩关节活动度两个维度评分观察组1和观察组2均优于对照组(P<0.05),疼痛和徒手肌力两个维度评分组间无差异。疼痛视觉评分仅观察组2低于对照组(P<0.05)。颈部僵硬情况三组间差异无统计学意义。结论多元化康复训练体系能改善甲状腺癌行颈淋巴结清扫术后患者的颈肩功能,缓解术后急性期疼痛。Objective To explore the effect of diversified rehabilitation training system on neck shoulder function in patients with thyroid cancer after neck dissection.Methods A total of 120 patients who underwent thyroid cancer resection and selective lymph node dissection in a hospital in Shanghai from May 2018 to November 2019 were selected as the research objects,who were divided into control group,observation group 1 and observation group 2 according to their admission time in average.The control group received routine postoperative nursing,while the observation group 2 implemented the diversified rehabilitation training system,and observation group 1 reduced the low-frequency electrotherapy during hospitalization compared with observation group 2.The pain score was measured at 1 day,2 days,3 days,1 week,1 month and 3 months,while neck and shoulder function were evaluated at 1 week,1 month and 3 months after operation.The difference of neck stiffness and scar in 1 month and 3 months were compared.Results The total score of shoulder function,activities of daily living and range of motion of shoulder joint in observation group 1 and 2 were better than those in control group(P<0.05).The pain visual score of observation group 2 was lower than that of control group(P<0.05).There was no significant difference in neck stiffness and scar among the three groups.Conclusions The diversified rehabilitation training system can improve neck shoulder function of patients with thyroid cancer after neck dissection and relieve postoperative acute pain.

关 键 词：康复训练体系 视频 低频电疗 甲状腺癌 颈淋巴结清扫 

分 类 号：R473.73[医药卫生—护理学]