早期综合护理干预预防乳腔镜下腋窝淋巴结清扫术后上肢淋巴水肿临床研究  

Clinical study of early comprehensive nursing intervention for prevention of lymphedema in axillary lymph nodes after endoscopic axillary lymph node dissection

作　　者：张鑫[1] 刘嘉琦[1] Zhang Xin;Liu Jiaqi(Department of Second Breast Surgery, Shengfing Hospital Affiliated to China Medical University, Shenyang 110022, China)

机构地区：[1]中国医科大学附属盛京医院第二乳腺外科,沈阳110022

出　　处：《中国实用护理杂志》2018年第13期989-992,共4页Chinese Journal of Practical Nursing

摘　　要：目的探讨早期综合护理干预预防乳腔镜下腋窝淋巴结清扫术后上肢淋巴水肿的可行性及安全性。方法本研究为前瞻性研究。依据患者纳入和排除标准，将2016年6月至2017年6月在中国医科大学附属盛京医院第二乳腺外科60例已行乳腔镜下腋窝淋巴结清扫术并采取早期综合护理干预的乳腺癌患者（观察组）作为研究对象，根据患者年龄及乳腺癌TNM分期1：1配对选择2015年6月至2016年5月60例已行乳腔镜下腋窝淋巴结清扫术而仅行早期常规护理的乳腺癌患者为对照组，采用上肢周径测量法作为淋巴水肿的诊断标准，比较2组患者术后上肢水肿的发生率。结果观察组上肢水肿发生率为3．3％（2／60），明显低于对照组的13．3％（8／60），差异有统计学意义（P=0．031）。结论乳腔镜下腋窝淋巴结清扫术后行早期护理干预，会明显降低上肢水肿发生率，减少了患者痛苦，提高了患者术后生命质量，值得临床推广。Objective To explore the feasibility and safety of early nursing intervention in the prevention of lymphedema after endoscopic axillary lymph node dissection. Methods This was a prospective study. Based on patient inclusion and exclusion criteria, 60 cases of patients underwent breast surgery with endoscopic axillary lymph node dissection for breast cancer and with early comprehensive nursing intervention in Shengjing Hospital affiliated to China Medical University from June 2015 to June 2017 were set as the observation group. Other 60 patients with endoscopic axillary lymph node dissection for breast cancer and with early routine care were set as the control group. The incidence of upper extremity edema were compared. Results The incidence of upper extremity edema in the observation group was 3.3%（2/60）, which was significantly less than 13.3%（8/60） in the control group with significant difference （P=0.031）. Conclusions Early nursing intervention after endoscopic axillary lymph node dissection can significantly reduce the incidence of upper limb edema, reduce the pain of patients and improve the quality of postoperative life, and is worthy of clinical promotion.

关 键 词：腹腔镜 乳腺肿瘤 上肢水肿 术后早期综合护理 

分 类 号：R473.73[医药卫生—护理学]