改良式体位引流联合胸部物理治疗在食管癌术后患者中的应用

目的：探讨胸部物理治疗联合改良式体位引流方法，应用于食管癌术后患者的效果。方法选取2010年10月-2012年10月在某院心胸外科行开胸食管癌根治术的患者60例，按时间顺序抽取30例手术患者设为观察组，30例手术患者为对照组。对照组术后在湿化痰液的基础上行常规胸部物理治疗：翻身、叩背、指导深呼吸和正确咳嗽。观察组在湿化痰液、常规胸部物理治疗的基础上，联合改良式体位引流，观察比较两组患者术后胸腔引流管拔除的时间、离床活动的时间、术后肺炎、肺不张发生情况。结果观察组患者术后胸腔引流管拔除时间、离床活动的时间分别为（2．433＆#177;1．063），（1．950＆#177;1．044）d，分别短于对照组的（3．066＆#177;1．112），（2．666＆#177;1．109）d，差异有统计学意义（t分别为2．263，3．006；P＜0．05）。观察组患者术后肺不张发生率为3．3％（1/30），低于对照组的16．7％（5/30），差异有统计学意义（χ2＝4．043，P＜0．05）；肺炎发生率比较差异无统计学意义（χ2＝0．218，P＞0．05）。结论胸部物理治疗联合改良式体位引流能有效地预防术后肺不张，有利于胸腔引流及肺功能恢复。

Application of chest physical therapy combined with improved postural drainage method in patients with esophageal cancer after operation

Objective To explore chest physical therapy combined with improved postural drainage method, applied in patients with esophageal cancer after operation .Methods A total of 60 patients with esophageal cancer after operation from October 2010 to October 2012 were selected and randomly divided into observation group （ n=30 ） and control group （ n=30 ） .Control group received the routine nursing such as chest physical therapy （roll over, right back, take a deep breath and cough） and wet phlegm,while observation group received the improved postural drainage on the basis of routine nursing .Then, compared two groups of removal time of chest drainage tube , from bed activity time , postoperative pneumonia , pulmonary atelectasis situation.Results Patients of chest drainage tube removal time （2.433 ＆#177;1.063） vs （3.066 ＆#177;1.112）], from bed activity time （1.950 ＆#177;1.044） vs （2.666 ＆#177;1.109）] in observation group was significantly shorten than that in control group （t =2.263,3.006;P ＆lt;0.05）.And the incidence of postoperative atelectasis in observation group was significantly lower than that in control group （3.3%vs 16.7%;χ2 =4.043,P＆lt;0.05）. While no significant difference was found in the incidence of pneumonia between observation group and control group （ P ＆gt;0.05 ）.Conclusions Chest physical therapy combined with improved postural drainage can effectively prevent the incidence of postoperative atelectasis , which is advantageous to chest drainage and the recovery of lung function and .