踩球运动对妇科恶性肿瘤患者术后下肢血流动力学的影响

Effects of step-ball exercise on postoperative lower limbs hemodynamic parameters in patients with gynecologic malignancies

目的探讨踩球运动对妇科恶性肿瘤术后患者下肢深静脉血流动力学的影响,为临床预防下肢静脉血栓形成提供参考。方法将40例妇科恶性肿瘤术后患者随机分为对照组和观察组各20例,在常规治疗和护理的基础上,对照组麻醉清醒后指导患者床上进行踝泵运动,观察组麻醉清醒后指导患者床上进行踩球运动。于首次运动前后及术后第3天观察两组下肢股静脉血流峰速及血流平均速度情况。结果术后首次运动不同时间点及术后第3天两组下肢血流峰速和血流平均速度比较,差异无统计学意义(均P>0.05)。组内单因素重复测量方差分析示,两组运动前后血流峰速和血流平均速度比较,差异有统计学意义(均P<0.01)。踩球运动或踝泵运动后立即及30min下肢静脉血流峰速和血流速度显著高于静息状态(均P<0.01)。结论对妇科恶性肿瘤术后患者行早期踩球运动可提高下肢血流速度,促进下肢血液回流,可以部分替代踝泵运动或作为踝泵运动的有益补充,作为预防下肢静脉血栓形成的干预措施。

Objective To explore the effects of step-ball exercise on lower limbs deep venous hemodynamic parameters in postoperative patients with gynecologic malignancies,and to provide reference for preventing lower limbs venous thrombosis in clinic. Methods Totally 40 postoperative patients with gynecologic malignancies were randomized into a control group and an experimental group,with 20 patients in each group.Based on routine treatment and nursing,the patients in the control group were instructed to do ankle pump exercise after anesthetic awareness,while the patients in the experimental group were guided to do step-ball exercise.The maximum blood velocity and mean blood velocity of femoral vein were observed for the two groups before and after the first exercise and the 3rd day after surgery. Results There were no significant differences in the maximum blood velocity and the mean blood velocity of lower limbs between the two groups at different time points ( P >0.05 for all).Anovariance analysis of single-factor repeated measurement within group indicated that,there were significant differences in the maximum blood velocity and the mean blood velocity before and after exercise for the two groups ( P <0.01 for both).The maximum blood velocity and the blood velocity of lower limbs vein immediately and 30 minutes after ankle pump exercise or step-ball exercise were significantly higher than those in resting state ( P <0.01 for all). Conclusion Step-ball exercise at an early stage for postoperative patients with gynecologic malignancies can increase lower limbs blood velocity,promote lower limbs blood reflux,which could replace ankle pump exercise in part or be used as a useful substitution for ankle pump exercise,and as an intervention measure to prevent lower limbs thrombosis.