内科理论与实践

内科理论与实践 ›› 2026, Vol. 21 ›› Issue (02): 145-152.doi: 10.16138/j.1673-6087.2026.02.07

• 论著 • 上一篇    下一篇

数字化踝泵运动打卡程序在静脉血栓高风险老年消化道肿瘤患者中的应用

金莹艳a,b, 曹伟伟a,b(), 张永怡a,b,c, 荣岚a,b,c, 于岚a,b,c   

  1. a. 上海交通大学医学院附属瑞金医院 护理部，上海　200025
    b. 上海交通大学医学院附属瑞金医院 老年病科，上海　200025
    c. 上海交通大学医学院附属瑞金医院 老年医学中心，上海　200025
  • 收稿日期:2025-12-30 修回日期:2026-01-14 接受日期:2026-02-03 出版日期:2026-04-25 发布日期:2026-06-15
  • 通讯作者: 曹伟伟 E-mail:cww22500@rjh.com.cn
  • 作者简介:作者贡献/Authors’ Contributions金莹艳负责研究构思设计、数据收集与整理、论文初稿撰写；曹伟伟负责研究构思设计、数据收集与整理、论文讨论修改；于岚负责数据整理、统计分析；张永怡负责 指导、论文审阅；荣岚负责指导、最终版本审核。

Application of a digital ankle pump exercise check-in program in elderly patients with gastrointestinal cancer at high risk of venous thromboembolism

JIN Yingyana,b, CAO Weiweia,b(), ZHANG Yongyia,b,c, RONG Lana,b,c, YU Lana,b,c   

  1. a. Ruijin Hospital, Shanghai Jiao Tong University School of Medicine Department of Nursing, Shanghai 200025, China
    b. Ruijin Hospital, Shanghai Jiao Tong University School of Medicine Department of Geriatrics, Shanghai 200025, China
    c. Ruijin Hospital, Shanghai Jiao Tong University School of Medicine Center for Geriatric Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Received:2025-12-30 Revised:2026-01-14 Accepted:2026-02-03 Online:2026-04-25 Published:2026-06-15

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摘要：

目的：探讨基于数字化打卡程序的踝泵运动干预方案对提升静脉血栓栓塞症高风险老年消化道肿瘤患者下肢血流动力学、运动依从性及预防效果的临床应用价值。 方法：采用前瞻性研究设计，于 2024 年 5 月1 日−12 月 31 日，选取上海交通大学医学院附属瑞金医院老年病科收治的 60 例Padua 评分≥4 分的老年消化道肿瘤患者作为研究对象。采用连续抽样法将其分为对照组和试验组，每组各 30 例，均接受为期 14 d的干预。对照组实施常规健康教育指导下的自主踝泵运动；试验组则依托自主研发的数字化踝泵运动打卡程序，实施标准化、可监督的踝泵运动干预。干预前（基线）及干预后第 1、7、14 天采用彩色多普勒超声测量并比较2组患者腘静脉内径与峰值流速；记录并分析踝泵运动的执行率、动作达标率及患者依从性；同时监测深静脉血栓的发生情况。结果：干预第 14 天，试验组腘静脉内径[（7.10±1.31） mm]显著大于对照组[（6.47±1.06） mm]（P <0.05），但在干预前、干预后第 1、7 天2组差异均无统计学意义。腘静脉流速存在显著的时间主效应（F时间=21.999，P<0.001）及时间与组别的交互效应（F交互=92.402，P<0.001）。组间比较显示，干预第 7、14 天试验组腘静脉流速[（7.78±1.03） cm/s、（8.25±1.08） cm/s] 均高于对照组[（7.04±1.29） cm/s、（6.93±1.25） cm/s]（P<0.05）。干预第 14天，试验组踝泵运动执行率（100.0%）与动作达标率（96.7%）均显著高于对照组（P<0.05）。干预期间，试验组未发生深静脉血栓，对照组发生 2 例（6.7%），但组间差异无统计学意义（P=0.492）。结论：数字化踝泵运动打卡程序作为一种结构化、可监测的干预工具，能够有效促进老年消化道肿瘤血栓高危患者下肢腘静脉的血管扩张与血流加速，并显著提升其踝泵运动的规范执行率与长期依从性，对预防下肢深静脉血栓形成具有积极的临床意义，为肿瘤患者静脉血栓栓塞症的规范化物理预防提供了可操作的数字化解决方案。

关键词: 踝泵运动, 数字化健康干预, 老年患者, 消化道肿瘤, 静脉血栓栓塞症, 血流动力学, 依从性

Abstract:

Objective To investigate the clinical application value of a digital check-in program-based ankle pump exercise intervention protocol in enhancing lower limb hemodynamics, improving exercise compliance, and preventing thrombosis in elderly gastrointestinal cancer patients at high risk of venous thromboembolism. Methods A prospective study design was adopted. From May 1 to December 31, 2024, 60 elderly gastrointestinal cancer patients with a Padua score ≥4 admitted to the Department of Geriatrics of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, were selected as the study subjects. Using a consecutive sampling method, they were divided into a control group and an experimental group, with 30 cases in each group. Both groups received a 14-day intervention. The control group performed self-guided ankle pump exercises under routine health education instruction, while the experimental group received a standardized and supervised ankle pump exercise intervention via a self-developed digital exercise check-in program. At pre-intervention (baseline) and on day 1, 7, and 14 of the intervention, color Doppler ultrasound was used to measure and compare the popliteal vein diameter and peak flow velocity between the two groups. The implementation rate and standard fulfillment rate of ankle pump exercises, along with patient compliance were recorded and analyzed. The incidence of deep vein thrombosis was also monitored in both groups. Results By day 14, the popliteal vein diameter in the experimental group [(7.10±1.31) mm] was significantly larger than that in the control group [(6.47±1.06) mm] (P<0.05), though no significant differences were observed at baseline or on day 1 and 7. Popliteal vein flow velocity showed significant main effect of time (F for time=21.999, P<0.001) and time-group interaction effect (F for interaction=92.402, P<0.001). Between-group comparisons showed that on day 7 and 14, the popliteal vein flow velocity in the experimental group [(7.78±1.03) cm/s and (8.25±1.08) cm/s] was significantly higher than that in the control group [(7.04±1.29) cm/s and (6.93±1.25) cm/s] (both P<0.05). On day 14 of the intervention, the implementation rate of ankle pump exercises in the experimental group (100.0%) and the movement standard fulfillment rate (96.7%) were both significantly higher than those in the control group (P<0.05). During the intervention, no deep vein thrombosis occurred in the experimental group, while 2 cases (6.7%) were observed in the control group, with no statistically significant between-group difference (P=0.492). Conclusions As a structured and monitorable intervention tool, the digital ankle pump exercise check-in program can effectively promote popliteal venous dilation and blood flow acceleration in elderly gastrointestinal cancer patients at high risk of thrombosis. It also significantly improves the standardized implementation rate and long-term compliance with ankle pump exercises. This intervention demonstrates positive clinical significance in preventing lower limb deep vein thrombosis and provides an operable digital solution for the standardized physical prophylaxis of venous thromboembolism in cancer patients.

Key words: ankle pump exercise, digital health intervention, elderly patients, gastrointestinal cancer, venous thromboembolism, hemodynamics, compliance