人文关怀及早期颈肩功能锻炼对喉癌术后康复的影响研究

摘要

目的：探讨护理人文关怀及早期颈肩功能锻炼对喉癌颈淋巴清扫术后患者康复的作用。方法将喉癌颈淋巴清扫手术治疗患者50例随机分为对照组和实验组，每组各25例。对照组按喉癌术后常规方法护理；实验组在此基础上应用人文关怀理论，尽早对患者术后面颈部水肿情况和患侧肩臂功能做出评估及康复锻炼计划，实施早期颈肩功能康复锻炼。该功能康复锻炼共分3个阶段，第l阶段主要是保护性功能锻炼，第2阶段为运动功能恢复锻炼，第3阶段主要为增强肌力的康复锻炼。于术后1d、3d、5d、7d测量面颈部肿胀消退情况，术后第1周起每周1次及出院前测评颈肩功能恢复情况及住院天数、焦虑抑郁程度和满意度。结果早期颈肩功能康复训练可防止和减轻患者面颈部及上肢的水肿情况，实验组患者颈肩部功能恢复情况、焦虑抑郁程度、住院天数、满意度明显优于对照组（ P＜0.05）。结论本组研究资料显示，人文关怀融入早期颈肩功能康复锻炼，能有效防止和减轻喉癌术后患者面颈部及上肢的水肿情况，有效促进颈肩功能的恢复，改善患者焦虑、抑郁状态，提高患者生活质量及满意度，对患者的全面康复具有积极、有效的作用。%Objective To explore the effect of the nursing humanistic care and early cervical shoulder function training on postoperative rehabilitation of patients with laryngeal dissection.Methods 50 patients with larynx cleaning surgical treatment were randomly divided into the control group and the experimental group , with 25 cases in each group.The control group received routine nursing according to laryngeal cancer surgery;and based on this , the experimental group used the theory of humanistic care , and the face and neck edema postoperatively and side shoulders and arms function assessment and rehabilitation training program.The “early neck and shoulder function rehabilitation training” was implemented.The functional rehabilitation training included three stages.The first stage mainly included protective function exercises, Stage 2 included motor function recovery exercise , and Stage 3 mainly included the recovery of muscle strength training improvement.In postoperative 1, 3, 5, 7 d, face and neck swelling subsided , postoperative 1 week and 1 times a week before discharge measurement neck and shoulder function recovery and hospitalization days , anxiety, depression and satisfaction degree were measured.Results Early neck and shoulder function rehabilitation training can prevent and reduce the patients ′face and neck and upper extremity edema.Degree of neck shoulder function recovery , anxiety, depression, hospitalization days and satisfaction in the experimental group is better than the control group ( P<0.05 ).Conclusion The research data shows , humanistic care into the neck and shoulder function of early rehabilitation training can effectively prevent and reduce the face and neck and upper extremity edema , effectively enhance the recovery of neck and shoulder function , improve the patients′anxiety and depression , improve the quality of life and satisfaction , and play an active and effective role on the comprehensive rehabilitation of patients.