Abstract:

Objective: To analyze the effect of early active limb movement in reducing postoperative pulmonary embolism (PE) in lung cancer patients. Methods: Using retrospective research method, according to enrolment criteria, 187 patients who had received surgical treatment of lung cancer in Shanghai Ninth People’s Hospital affiliated to Shanghai Jiaotong University School of Medicine from January to December 2019 were selected as control group, and 194 patients treated from January to December 2020 were selected as observation group. The control group was given routine nursing, while the observation group took early active limb activity on top of routine nursing. We compared the levels of platelet indicators (PLT, PDW, MPV) and fibrinolytic indicators (PAI-1, tPA, D-dimer) between the two groups of patients on postoperative day 1 and 7, as well as the incidence of PE within 1 and 7 days, the survival of patients in 7-day, 1-month, 6-month, 1-year, and 3-year periods after surgery. Results: The incidence of MPV ((7.29±0.51) fl and (7.22±0.82) fl), PLT ((173.13±21.56)×10⁹/L and (169.11±19.64)×10⁹/L), PAI-1 ((6.61±0.80) AU/ml and (6.53±1.21) AU/ml), tPA ((0.81±0.21) IU/ml and (0.82±0.11) IU/ml) on day 1 and day 7, and D-dimer ((0.31±0.11) mg/L) on day 1, as well as the incidence of PE (2.58% (5/194)) on day 7 were lower in the observation group than in the control group ((8.23±0.69) fl and (8.11±1.13) fl, (184.56±23.71)×10⁹/L and (181.61±21.78)×10⁹/L, (7.41±1.22) AU/ml and (7.32±1.11) AU/ml, (0.92±0.21) IU/ml and (0.91±0.41) IU/ml, (0.41±0.11) mg/L, and 9.63% (18/187)), whereas the survival rates (85.57% (166/194) and 63.40% (123/194)) at 1 and 3 years after surgery were significantly higher than those of the control group (70.05% (131/187) and 51.87% (97/187)), and the differences were statistically significant in all cases (t=18.294, P=0.043; t=15.011, P=0.039; t=20.415, P=0.048; t=19.669, P=0.046; t=18.214, P=0.028; t=19.015, P=0.032; t=17.141, P=0.033; t=18.011, P=0.039; t=15.326, P=0.049; χ²=8.195,P=0.019; χ²=5.148, P=0.031; χ²=7.047, P=0.007). No patient developed PE on postoperative day 1 in either group, and there were no deaths within 7 days or 1 month. Conclusion: Early active limb activity program can reduce the incidence of postoperative PE in patients with lung cancer, improve the prognosis of patients and prolong the survival period, which is worthy of promotion and application.

Key words: Lung neoplasms, Pulmonary surgical procedures, Pulmonary embolism, Perioperative nursing, Behavior therapy, Nursing evaluation research