食管癌围手术期的物理治疗进展

doi:10.3969/j.issn.1006-9771.2019.10.009

摘要/Abstract

摘要： 食管癌是我国最常见的消化道恶性肿瘤，目前手术切除仍是治愈食管癌的主要方法。随着加速康复外科理念的提出和实施，围手术期的物理治疗越来越受到重视。本文探讨食管癌患者术前心肺功能评估的必要性，术前的呼吸训练和有氧运动对优化患者体能和减少术后并发症的作用，以及术后早期物理治疗的内容。食管癌患者术前心肺功能与预后关系微弱，可能与食管癌手术的复杂性和术后并发症的高发性有关。术前的吸气肌训练一定程度上能够提高患者的肺功能，但目前还缺乏大样本量的研究；术前的有氧运动能够提高患者的体能储备，应受到重视。食管癌术后早期的物理治疗内容包括疼痛管理、胸部的物理治疗和早期活动，早期活动的运动处方如强度、时间等还有待进一步研究。

关键词: 食管癌, 康复, 物理治疗, 综述

Abstract: Esophageal cancer is the most common malignant tumor of the digestive tract in China. At present, surgical resection is the main method to cure esophageal cancer. With the population and implementation of the enhanced recovery after surgery, perioperative physical therapy plays a more and more important role. This review discussed the necessity of preoperative cardiopulmonary function assessment in patients with esophageal cancer, the effects of preoperative respiratory training and aerobic exercise on optimizing physical fitness and reducing postoperative complications, and the content of early postoperative physical therapy. Preoperative cardiopulmonary function of esophageal cancer patients is not strongly related with the outcome, which may be related to the complexity of esophageal cancer surgery and the high incidence of postoperative complications. Preoperative inspiratory muscle exercise can improve the pulmonary function of patients to some extent, but still lack of large sample size research. Preoperative aerobic exercise for esophageal cancer can improve the patient's physical reserve and should be valued. Postoperative physiotherapy priorities includes pain management, chest physical therapy and early mobilization. Exercise prescriptions such as intensity and time for early mobilization are yet to be further studied.

Key words: esophageal cancer, rehabilitation, physical therapy, review

中图分类号:

R735.1

王龙平, 曾斌, 白文芳, 邓澄, 吴映红, 乔贵宾. 食管癌围手术期的物理治疗进展[J]. 《中国康复理论与实践》, 2019, 25(10): 1168-1171.

WANG Long-ping, ZENG Bin, BAI Wen-fang, DEGN Cheng, WU Ying-hong, QIAO Gui-bin. Advance in Perioperative Physical Therapy for Esophageal Cancer (review)[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2019, 25(10): 1168-1171.

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