肩颈部运动训练干预对甲状腺癌术后患者的影响

Influence of Shoulder and Neck Exercise Training Intervention in Patients after Thyroid Cancer Surgery

目的:探究肩颈部运动训练干预对甲状腺癌术后患者的影响。方法:选取福建省立医院2019年1月-2020年12月收治的116例甲状腺癌患者。随机将其分为试验组(58例)和对照组(58例)。对照组术后给予常规护理,观察组在对照组基础上给予肩颈部运动训练干预。比较两组切口愈合时间及术后1个月的温哥华瘢痕量表(VSS)评分。比较两组干预7 d后的颈部活动度,干预前及干预后3个月的Neer肩关节功能评分。比较两组术后3个月内并发症。结果:试验组切口愈合时间早于对照组,术后1个月的VSS评分低于对照组(P<0.05)。干预7 d后,试验组向健侧屈伸、旋转和向患侧屈伸、旋转及前屈、后伸活动度均显著大于对照组(P<0.05)。干预后3个月,两组疼痛、功能、运动范围评分均显著高于干预前(P<0.05),试验组功能、运动范围评分均显著高于对照组(P<0.05)。术后3个月内试验组肩臂综合征发生率低于对照组(P<0.05),两组喉返神经损伤发生率比较差异无统计学意义(P>0.05)。结论:肩颈部运动训练干预可缩短甲状腺癌术后患者的切口愈合时间,有助于促进伤口与肩颈功能恢复,减轻瘢痕形成,对甲状腺癌术后患者的疾病转归可起到积极作用。

Objective:To explore the influence of shoulder and neck exercise training intervention on patients after thyroid cancer surgery.Method:A total of 116 patients with thyroid cancer admitted to Fujian Provincial Hospital from January 2019 to December 2020 were selected.They were randomly divided into experimental group(58 cases)and control group(58 cases).The control group was given routine nursing after surgery,and the experimental group was given shoulder and neck exercise training intervention on the basis of the control group.The incision healing time and the Vancouver scar scale(VSS)scores at 1 month after surgery were compared between the two groups.The neck range of motion after 7 d of intervention and Neer shoulder joint function scores before intervention and at 3 months after intervention of the two groups were compared.The complications within 3 months after surgery were compared between the two groups.Result:The incision healing time of the experimental group was earlier than that of the control group,and the VSS scores at 1 month after surgery was lower than that of the control group(P<0.05).After 7 d of intervention,the ranges of motions of flexion and extension,rotation to the healthy side,flexion and extension,rotation to the affected side,forward flexion and backward extension in the experimental group were significantly greater than those in the control group(P<0.05).At 3 months after intervention,the scores of pain,function and range of motion in the two groups were significantly higher than those before intervention(P<0.05),and the scores of function and range of motion in the experimental group were significantly higher than those in the control group(P<0.05).The incidence of shoulder arm syndrome in the experimental group was lower than that in the control group within 3 months after surgery(P<0.05),but there was no significant difference in the incidence of recurrent laryngeal nerve injury between the two groups(P>0.05).Conclusion:Shoulder and neck exercise training intervention can shorten the incision healing time of patients after thyroid cancer surgery,help to promote the recovery of wound and shoulder and neck function,and reduce the scar formation.It can play a positive role in the disease outcomes of patients after thyroid cancer surgery.